Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

​​​Quality Management Program promotes quality care and service​

July 7, 2023

​As a participating provider, you have agreed to comply with Independence Blue Cross's Quality Management Program to support optimal health outcomes and satisfaction with care for our members.

Please review our standards of care with your staff related to:

Our member safety and wellness initiatives promote efficient utilization of services, facilitate coordination of care, promote adherence to the plan of care, and help improve outcomes.

  • Complex case management. Members with complex medical or behavioral health conditions may be eligible for case management. You can refer members online or by calling 1-800-313-8628.
  • Drug utilization review. Targeted reports are generated annually related to prescribing and care coordination practices. Reports are sent via mail to your practice, if applicable.
  • Occurrence investigation. Our clinical staff, with Medical Director oversight, reviews all reported occurrences for quality issues. Medical records may be requested for a detailed analysis and, if necessary, a corrective action plan can be obtained from the facility or provider.
  • Blue Distinction® Specialty Care. Blue Distinction® Centers and Blue Distinction Centers+ are recognized through this program when they meet stringent, objective national criteria for excellence in outcomes. For more information about criteria, visit the BCBSA website.

Learn more about our Quality Management Program by visiting our website; reading the Quality Management section of the Provider or Hospital Manual; or calling Customer Service at 1-800-ASK-BLUE (1-800-275-2583).


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.