Provider Tools & Resources

A library of communications, programs, forms, guides, quality standards, policies and more to assist physicians, staff and other health care providers in navigating their roles in providing care for our members.

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Everything you need, all in one place.

The provider manual and supplemental guides, forms, frequently asked questions, online training, helpful external links and information about our clinical programs. It's all here.

Manual for Physicians and Providers

Get answers to your questions about our business requirements, networks, products, programs and coding and claims filing guidelines.

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Forms

Find commonly used physician, provider and member forms for you to complete and send to us.

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Medical & Pharmacy Policies and Guidelines

Help your Florida Blue patients understand their health insurance as it relates to medical and pharmacy benefits and policies.

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Online Training

Stay connected with online web-based training created specifically for physicians, other health care providers and administrative staff.

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Programs

Use a variety of programs to help improve the coordination and quality of care for our members through value-based health care.

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Companion Documents

Clarifies data content for the exchange of HIPAA-mandated electronic transactions between trading partners and health plans

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Federal Employee Program

Learn about our nationwide Blue Cross and Blue Shield PPO coverage for federal employees, retirees, surviving spouses and eligible dependents.

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Quality / HEDIS / CAHPS

Find national standards, guidelines and patient health care experience survey information supporting quality care and best practices.

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HEDIS Measures Tip Sheets

Use these tip sheets to find key quality standards to help improve your patient health outcomes and close care gaps

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Medicare Stars

Find information, tools and resources to help you navigate through our Medicare Stars program.

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News & Announcements

Your one-stop shop to find important news in one convenient place including archived Bluemail email and Bulletins and FAQs.

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