The Provider Manual for Participating Professional Providers (Provider Manual) is part of a provider's Professional Provider Agreement with Independence Blue Cross and its affiliates (collectively referred to as "Independence").
The manual was developed to assist participating professional providers in conducting business with Independence in accordance with the Provider Agreement.
The Provider Manual is an easy-to-use reference tool, color-coded, and hyperlinked to provide easy access to the information that providers need most. It is updated regularly to provide pertinent information regarding our policies, procedures, and functions.
Providers may request a print version of the Provider Manual by submitting a request through our online order form.
- Introduction (December 2021)
- General Information (October 2021)
- Administrative Procedures (November 2022)
- Fraud, Waste, & Abuse (October 2021)
- Medical Policy & Claim Payment Policy (June 2021)
Clinical Services – Utilization Management (October 2021)
- Quality Management (December 2021)
- Behavioral Health (June 2021)
- Billing (October 2021)
Hospitalization and Outpatient Services (December 2021)
Specialty Programs (October 2021)
OB/GYN (October 2021)
Health and Wellness (December 2021)
Pharmacy (March 2022)
Appeals (June 2021)
BlueCard® (October 2021)
Disclaimer Information (December 2021)