Providers

Provider Manual

Last Updated: November 10, 2023 at 3:57 pm

The provider manual provides important information about BCBSAZ Health Choice Pathway.

Chapter 1

Introduction to BCBSAZ Health Choice Pathway
(Updated - 04/19/2023 06:01 PM)
Exhibit 1-1 Provider Escalation Notice
(Updated - 10/12/2023 02:26 PM)

Chapter 2

Member Services
(Updated - 04/19/2023 05:43 PM)
Exhibit 2.1 Member Dual ID Card
(Updated - 04/19/2023 05:32 PM)
Exhibit 2.2 Medicare ID Card
(Updated - 04/19/2023 05:32 PM)

Chapter 3

Provider Responsibility
(Updated - 08/02/2023 04:42 PM)

Chapter 4

Cultural Competency
(Updated - 11/09/2023 03:14 PM)

Chapter 5

Quality Management
(Updated - 04/19/2023 05:36 PM)

Chapter 6

Medical Authorizations and Notifications
(Updated - 11/09/2023 03:18 PM)
Exhibit 3-6.12 Maternal Risk Assessment Form
Exhibit 5-1 Care Management Referral Form
(Updated - 04/19/2023 05:45 PM)
Prior Authorization Guidelines effective 8/10/2023
(Updated - 08/27/2023 05:34 PM)
Prior Authorization Guidelines effective 5/1/2023
(Updated - 05/03/2023 07:32 PM)
Prior Authorization Guidelines effective 2/1/2023
(Updated - 01/30/2023 10:57 PM)
Prior Authorization Guidelines effective 11/5/2022
(Updated - 11/01/2022 10:54 PM)
Prior Authorization Guidelines effective 4/1/2022
Prior Authorization Guidelines effective 10/1/2021
(Updated - 09/14/2021 04:51 PM)
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 06:01 PM)

Chapter 9

Grievance, Appeals, Claim Resubmission and Reconsiderations
(Updated - 08/02/2023 04:42 PM)

Chapter 10

Drug Formulary
(Updated - 02/14/2023 08:40 AM)
Exhibit 17-1 Pharmacy Medication Prior Authorization Form

Chapter 11

Transplant Services
(Updated - 04/19/2023 05:44 PM)

Chapter 12

Covered Benefits
(Updated - 05/25/2023 06:02 PM)
Exhibit 12-1 Supplemental Benefit Comparison Chart
(Updated - 07/07/2023 10:37 AM)
Exhibit 12-2 2023 CPT Codes for Supplemental Benefits
(Updated - 04/19/2023 10:08 AM)

Chapter 13

Care Management
(Updated - 11/09/2023 01:29 PM)

Download Adobe Acrobat Reader

You are leaving BCBSAZ Health Choice Pathway

This link will take you away from the Medicare section of healthchoicepathway.com

You will be redirected to

Click the link above to continue or CANCEL