Policies and guidelines
Use this online searchable database to read Independence Blue Cross medical and claim payment policies.
Clinical practice guidelines
Download guidelines that outline generally accepted minimum standards of care. Adherence to these standards may lead to improved patient outcomes.
Precertification and cost-share requirements
Learn what services require preapproval/precertification from Independence prior to being performed.
Dosage and Frequency Program
Learn how Independence reviews treatment regimens for certain specialty drugs to ensure they adhere to safe prescribing limits.
Most Cost-effective Setting Program
Find out how Independence reviews the requested treatment settings for certain specialty drugs that are eligible for coverage under the medical benefit.
Medical policy/precertification inquiry
Use this electronic form to look up medical policy or preapproval/precertification information for out-of-area Blue plan members.
Forms and compliance
Access the most commonly used forms, such as continuity of care requests, provider changes, HIPAA authorizations, and physician referrals.
Learn more about the various drug formularies offered to Independence Blue Cross members, and search for covered drugs.
Find Independence Blue Cross pharmacy policies related to specific pharmaceutical agents.
Understand what constitutes a specialty medical benefit drug and view a complete list of those covered under the member’s medical benefit.
Direct Ship Drug Program
This program allows in-network providers to order select specialty medical benefit drugs for administration in the office.
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