HMO IPA/Medical Group Procedures Manual

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 65 PlusSM plans). You'll need Adobe Reader to view the manual.

Content by section

Forms

Download and print commonly requested patient care, prior authorization and network forms.

Find forms for Blue Shield of California providers

Find forms for Blue Shield Promise providers

Guidelines and procedures

Find operating guidelines for clinical practices, preventive health and procedures for continuing network participation.

Read guidelines

Policies and standards

Find medication policies information and standards for HIPAA transactions, medical records and more.

Read about our policies and standards

Drugs and pharmacy resources

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.

Find pharmacy resources