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Operations management

Information to help you understand and administer benefits.

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 Programs

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

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