This manual describes the policies and operating procedures for HMO IPAs and medical groups that contract with Blue Shield of California to provide healthcare services for members of our HMO plans (including our Access+ HMO®, Trio HMO and Blue Shield Medicare Advantage plans). You'll need Adobe Reader to view the manual.
Download Section 1 (PDF, 79 KB)
Download Section 2 (PDF, 383 KB)
Download Section 3 (PDF, 142 KB)
Download Section 4 (PDF, 620 KB)
Download Section 5 (PDF, 640 KB)
Download Section 6 (PDF, 597 KB)
Download and print commonly requested patient care, prior authorization and network forms.
Find medication policies information and standards for HIPAA transactions, medical records and more.
Search our drug formulary database, find prior authorization forms and procedures for different types of prescriptions, learn about our mail service pharmacy for medication delivery and find out about generic alternatives.