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.
Provider Manual
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Introduction (December 2021)
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General Information (May 2023)
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Administrative Procedures (April 2024)
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Fraud, Waste, & Abuse (October 2021)
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Medical Policy & Claim Payment Policy (June 2021)
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Clinical Services – Utilization Management (May 2023)
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Quality Management (February 2024)
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Behavioral Health (December 2023)
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Billing (October 2021)
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Hospitalization and Outpatient Services (December 2021)
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Specialty Programs (May 2023)
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OB/GYN (May 2023)
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Health and Wellness (January 2024)
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Pharmacy (March 2022)
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Appeals (May 2023)
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BlueCard® (October 2021)
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Disclaimer Information (April 2023)