​Provider Manual f​or Participating Professional Providers

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.

Provider Manual

  1. Introduction (June 2021)
  2. General Information (July 2021)
  3. Administrative Procedures (June 2021)
  4. Fraud, Waste, & Abuse (June 2021)
  5. Medical Policy &​ Claim Payment Policy (June 2021)
  6. Clinical S​ervices – Utilization Management (June 2021​​)
  7. Quality Management (June 2021)
  8. Behavioral Health (June 2021)
  9. Billing (June 2021)
  10. Hospitalization and Outpatient Services (June 2021)
  11. Specialty Programs (June 2021)
  12. OB/GYN (June 2021)
  13. Health and Wellness (June 2021)
  14. Pharmacy (June 2021)
  15. Appeals​ (June 2021)
  16. BlueCard® (June 2021)
  17. Disclaimer Information (June 2021)