Policies and Guidelines

We know how complicated the health insurance and managed care industry has become. We also understand how that complexity can impact patient care, as well as your bottom line.

That's why we're offering all of our policies and guidelines in one, easy-to-access section. Here you'll find all you need to know about our products, services, claims and reimbursement process, drug therapy guideline and patient safety resources.

We're here to help you. That's our bottom line.

Access Drug Therapy Guidelines


To ensure thorough consideration of both quality-of-care and economic issues, some drugs require prior authorization.
We work with a committee of local physicians and pharmacists to identify medications that should require this kind of authorization and to develop the medical criteria used to determine when coverage is appropriate.
Learn More

Educate Yourself About Patient Safety


Useful Links


Preventive Services

Access information about our preventive services and recommendations.

Partners in Practice

Get help balancing your business practice with your patients' needs. 

OIG Alert About Charging Extra for Covered Services

Stay informed on industry news pertaining to providers, suppliers and physicians. 

FAQ: NYS Opioid Legislation Inpatient SUD

Initial 14 days of inpatient substence abuse disorder treatment. 


Provider Manuals


BlueCross BlueShield Dental Manual

Learn about our dental products, claims information, and provider reimbursement process.

Provider and Facility Reference Manual
Get information about our products, services, policies, and procedures.


Office Administrative Guidelines

Print, save or view our office administration documents.

Practice Guidelines