• Communications

• BlueCard

• National Provider Identifier (NPI)

• NaviNet

• Private Fee-for-Service

• Policies & Guidelines

• Claims and Billing Information

• Electronic Data Interchange (EDI) Services
• Claims Requirements and Communications
• Clear Claim Connection

• Forms

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• Physician Advisory Committee

• Prescription Drug Formulary & Prior Authorization

• IVR (Interactive Voice Response)

• Preapproval/Precertification for Services

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Claims Requirements and Communications

• Paper referrals no longer accepted
• Key Fields Must Be Entered Correctly on CMS-1500
• New UB-04 Form and Instructions
• Current and Revised 1500 Claim Forms and Instructions