提供者手冊

提供者手冊提供了有關BCBSAZ Health Choice Pathway的重要資訊。


Chapter 1	Introduction to BCBSAZ Health Choice Pathway Exhibit 1-1 Provider Escalation Notice ^{(Updated - 10/12/2023)}
Chapter 2	Member Services ^{(Updated - 04/19/2023)} Exhibit 2.1 Member Dual ID Card Exhibit 2.2 Medicare ID Card
Chapter 3	Provider Responsibility ^{(Updated - 08/02/2023)}
Chapter 4	Cultural Competency ^{(Updated - 11/09/2023)}
Chapter 5	Quality Management ^{(Updated - 04/19/2023)}
Chapter 6	Medical Authorizations and Notifications ^{(Updated - 11/09/2023)} Exhibit 3-6.12 Maternal Risk Assessment Form Exhibit 5-1 Care Management Referral Form Prior Authorization Grid effective 1/5/24 Prior Authorization Grid effective 11/15/23 ^{(Updated - 11/15/2023)} Prior Authorization Grid effective 8/10/2023 Prior Authorization Grid effective 5/1/2023 Prior Authorization Grid effective 2/1/2023 ^{(Updated - 01/30/2023)} Exhibit 6-2 Medical Services and Behavioral Prior Authorization Form Exhibit 17-1 Pharmacy Medication Prior Authorization Form
Chapter 7	Inpatient & Outpatient Hospital Care
Chapter 8	Coordination of Benefits or Other Insurance Liability ^{(Updated - 04/19/2023)}
Chapter 9	Grievance, Appeals, Claim Resubmission and Reconsiderations ^{(Updated - 08/02/2023)}
Chapter 10	Drug Formulary ^{(Updated - 02/14/2023)} Exhibit 17-1 Pharmacy Medication Prior Authorization Form
Chapter 11	Transplant Services ^{(Updated - 04/19/2023)}
Chapter 12	Covered Benefits Exhibit 12-1 2023 – 2024 Supplemental Benefit Comparison Chart Exhibit 12-2 2024 CPT and CDT Codes for Supplemental Benefits American Specialty Health (ASH) Provider Search