Provider Resources Overview
We are committed to supporting you in providing quality care and services to the members in our network. Here, you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits to our members.
Provider Forms
Provider forms are located in our online library for easy access.
Policies, Manuals, and Guides
Healthy Blue provider manuals and guides provide key administrative information, including the quality improvement program, the utilization management program, quality standards for participation, claims appeals, reimbursement and administration policies.
Training Academy
Healthy Blue offers training and tutorials to support providers in continuing their education. Presentations, videos, and other training documentation will be added as they become available.
Learn About Availity
Many of the tools you need — such as eligibility and benefits inquiry, claims submission, claims status inquiry and authorizations — can now be accessed by logging into your account on Availity.*
Prior Authorizations
Healthy Blue makes determinations based on selected inpatient or outpatient medical services including surgeries, major diagnostic procedures, and referrals to validate medical necessity.
Additional Information
Behavioral Health
Healthy Blue behavioral health provider network includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and employee assistance health care professionals. Our facility network includes hospital inpatient units, residential treatment centers, partial hospitalization programs, and intensive outpatient services and programs.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Provider Tools & Resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Eligibility Overview
- Provider Manual and Guides
- Provider Search Tool
- Forms
- Training Academy
- Electronic Data Interchange (EDI)
- Quality of Care Incident Form