Change notification
January 2024 Provider Manual change notification letter (PDF, 202 KB)
Complete manual
September 2023 HMO IPA/Medical Group Procedures Manual (PDF, 3.5 MB)
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.
January 2024 Provider Manual change notification letter (PDF, 202 KB)
September 2023 HMO IPA/Medical Group Procedures Manual (PDF, 3.5 MB)
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)
Appendix for Section 1 (PDF, 188 KB)
This manual does not contain an Appendix for Section 2
Appendix for Section 3 (PDF, 145 KB)
Appendix for Section 4 (PDF, 510 KB)
Appendix for Section 5 (PDF, 359 KB)
Appendix for Section 6 (PDF, 230 KB)
Download and print commonly requested patient care, prior authorization and network forms.
Find operating guidelines for clinical practices, preventive health and procedures for continuing network participation.
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.