PA Resources Portlet

Resources

CODING & DOCUMENTATION

EDUCATION & EVENTS

ENROLLMENT & CREDENTIALING

FORMS & MANUALS

PATIENT HEALTH

PHARMACY

POLICIES & GUIDELINES

Advanced Imaging

Autism Spectrum Mandate

Behavioral Health

Blue Advantage Policies

Chronic Condition Management

Clinical Practice Guidelines

COVID-19

HealthSmartRx Smart RxAssist

Hemophilia Drug Management

Medical Nutrition Therapy Services

Medical Policies

Medical Records Requests

No Surprise Billing Act

Operational Guidelines

Provider Appeals

Provider Disputes

Provider-Administered Drug Policies (Excluding Oncology)

Provider-Administered Oncology Drug Policies

Radiation Therapy Management (RTM)

Self-Administered Drug Policies

Subrogation

Telehealth and Remote Access Telemedicine

Transgender Services

PRE-SERVICE REVIEW

PROGRAMS & INITIATIVES

PROVIDER eSOLUTIONS

PROVIDER NETWORKS & SPECIALTIES

PA Dynamic Rendering

Operational Guidelines

Co-Surgeons and Team Surgeons

Under certain circumstances the skills of two surgeons (usually with different specialties) may be required in the management of a specific surgical procedure.
Drug Waste Guideline: Provider-Administered* Drugs or Biologicals
Low-Back Pain Imaging Studies and Modifier KX Operational Policy
Management of Hyperbilirubinemia in Newborns: Follow-Up Visits
Pediatric and Neonatal Critical Care Services and Intensive (Non-Critical) Care Services
PMD Providers in Contiguous Counties/Out-of-State Members

Blue Cross and Blue Shield of Alabama has claims processing rules for providers in contiguous counties to validate whether or not a member lives in Alabama.
Professional and Technical Components of X-rays

There are a number of diagnostic x-ray procedures that have professional and technical components. Blue Cross and Blue Shield of Alabama requires global billing for services rendered in an in-office setting for diagnostic services.
Seasonal Vaccines
Surgery-Related Claims Filing Updates