Medical policy and prior authorization
Learn about medical policies and review the Blue Cross medical policy database. Learn about prior authorizations and find out whether a service needs a prior auth.
View medical policy and prior authorization information
Autism Spectrum Disorder (ASD) Early Detection Resources
Developmental, Screening and Identification, and additional resources from a joint Minnesota state agency effort and Center for Disease Control.
View Autism Spectrum Disorder resources - Opens in a new window - Opens PDF in a new window
Reducing chronic opioid use
Tools to reduce chronic opioid use, such as a provider toolkit for acute opioid prescribing and information on covered alternative pain management therapies for Medicaid.
Meeting the challenges of opioids and pain - Opens in a new window - Opens PDF in a new window
Blue surgery safety checklist
Adopted from the World Health Organization Surgical Checklist, this checklist includes 19 steps designed to improve communication and consistency of care within surgical teams.
Download the checklist - Opens in a new window - Opens PDF in a new window
Electronic prior authorization (ePA-Rx) for prescription drugs
How to submit an electronic prior authorization request for a prescription drug based on a medical necessity review.
Formularies and drug programs
Access forms and information related to prescription drug benefits.
Learn more about prescription drug benefits
Request for prescription drug coverage exception - Opens in a new window
Home care service authorization process: MSHO, MSC+ and Families & Children
Information for county case managers and home care providers.
Nursing facility authorization process: MSHO and MSC+
Information for county case managers and nursing facility providers.
Reimbursement policies
Access Blue Cross reimbursement policies
Quality Measurement Specifications Availity Learning Center
The Centers for Medicare and Medicaid Services (CMS) Star Ratings Program is intended to measure the overall quality of care and services Medicare Advantage plans provide to Medicare beneficiaries.
Log in at Availity Learning Center - Opens in a new window
HIPAA companion guides
Use these guides for implementing the ASC X12N Standard Transactions.
HIPAA 270/271 Companion Guide - Opens in a new window - Opens PDF in a new window
HIPAA 276/277 Companion Guide - Opens in a new window - Opens PDF in a new window
ICD-10 resources
CMS ICD-10 Provider Resources - Opens in a new window
American Health Management Association - Opens in a new window
AAPC - Opens in a new window
ICD-10 Training Tool from World Health Organization - Opens in a new window
ICD-10 Watch - Opens in a new window
Medical Terminology Course with ICD-10 Training from Des Moines University - Opens in a new window
Medical codes — what's in and what's out - Opens in a new window - Opens PDF in a new window
Provider Toolkit
Can't find what you're looking for here? Check the Provider Toolkit.
Provider contact information
Mailing addresses, phone and fax numbers.