Medical policy and prior authorization
Learn about medical policies and review the Blue Cross medical policy database. Learn about prior authorizations and find out whether a service needs a prior auth.
Autism Spectrum Disorder (ASD) Early Detection Resources
Developmental, Screening and Identification, and additional resources from a joint Minnesota state agency effort and Center for Disease Control.
View Autism Spectrum Disorder resources
Reducing chronic opioid use
Tools to reduce chronic opioid use, such as a provider toolkit for acute opioid prescribing and information on covered alternative pain management therapies for Medicaid.
Provider toolkit: Meeting the challenges of opioids and pain
Blue surgery safety checklist
Adopted from the World Health Organization Surgical Checklist, this checklist includes 19 steps designed to improve communication and consistency of care within surgical teams.
Download the checklist
Electronic prescriptions (e-prescribing)
Write and electronically submit prescriptions to a pharmacy directly from the point of care. Access your patient's eligibility, medication history and drug formulary.
Learn more e-prescribing
Electronic prior authorization (ePA-Rx) for prescription drugs
How to submit an electronic prior authorization request for a prescription drug based on a medical necessity review.
Learn more about ePA-Rx
Formularies and drug programs
Access forms and information related to prescription drug benefits.
Learn more about prescription drug benefits
Request for prescription drug coverage exception
Home care service authorization process: MSHO, MSC+ and Families & Children
Information for county case managers and home care providers.
Learn more about home care service authorization process
Nursing facility authorization process: MSHO and MSC+
Information for county case managers and nursing facility providers.
Learn more about nursing facility authorization process
Reimbursement policies
Access Blue Cross reimbursement policies
See reimbursement policies
Quality Measurement Specifications Availity Learning Center
The Centers for Medicare and Medicaid Services (CMS) Star Ratings Program is intended to measure the overall quality of care and services Medicare Advantage plans provide to Medicare beneficiaries.
Log in at Availity Learning Center
Payment transformation
Learn about payment methodologies for all critical access and acute care hospitals and ambulatory surgery centers.
Learn more about payment transformation
Blue Cross and Blue Shield of Minnesota HIPAA companion guides
Use these guides for implementing the ASC X12N Standard Transactions.
HIPAA 270/271 Companion Guide
HIPAA 276/277 Companion Guide
ICD-10 resources
CMS ICD-10 Provider Resources
American Health Management Association
AAPC
ICD-10 Training Tool from World Health Organization
ICD-10 Watch
Medical Terminology Course with ICD-10 Training from Des Moines University
Information of Medical Codes - what's in and what's out