Providers
COVID-19 provider hub  

Policies and guidelines

Operations management

Medical policy

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.

Pre-service review for out-of-area members

Use NaviNet Open to request electronic pre-service reviews for out-of-area members by accessing the provider portal of the member’s Home Plan.

Pharmacy information

Drug formularies

Learn more about the various drug formularies offered to Independence Blue Cross members, and search for covered drugs.

Prior authorization

Read about our prior authorization requirements for certain covered drugs.

Pharmacy policies

Find Independence Blue Cross pharmacy policies related to specific pharmaceutical agents.

Blood glucose meter

Find out how your patients can get free blood glucose meters to help them manage diabetes.

Specialty medical drugs

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.

NaviNet® is a registered trademark of NantHealth, an independent company.