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Welcome

The BCBSIL Provider Manuals are comprehensive guides for Blue Cross Community Health Plans^SM, Blue Cross Community MMAI (Medicare-Medicaid Plan)^SM, Blue Cross Medicare Advantage (HMO)^SM, Blue Cross Medicare Advantage (PPO)^SM, Blue Choice PPO^SM, HMO, PPO and Blue High Performance Network^SM (Blue HPN^SM) EPO professional and facility providers. These manuals set forth the detailed policies, procedures and requirements necessary for participation in the BCBSIL contracting provider networks.

We hope these manuals make your interaction with us as efficient as possible by clarifying administrative requirements that support health care services provided to our members and your patients. Our goal is to collaborate with you in reducing administrative costs.

BCBSIL will update these manuals periodically as changes are needed and new information becomes available. While it is possible to print the manuals or their sections, it is important to refer to the BCBSIL Provider website for the most current and complete version of each manual.

The manuals are organized into sections for your convenience. We have also identified documents, resources and information specifically designed for PPO, HPN, HMO, MA HMO, MA PPO, BCCHP and MMAI network providers and IPAs. Click on a section title to view the content.

Instructions for Blue Choice PPO, Blue Cross Medicare Advantage PPO, PPO and HPN Providers
Instructions for HMO/Blue Cross Medicare Advantage HMO Medical Groups/IPAs