Why you need the manuals

Our provider manuals specifically address Blue Shield of California Promise Health Plan's contractual and regulatory requirements and are an extension of our provider agreement with your practice or facility.

The provider manual contains the policies, procedures, reference information, and minimum care standards required of Blue Shield Promise providers.

Change notifications

   January 2021 Blue Shield Promise Cal MediConnect Provider Manual Change Notification letter (PDF, 120KB)
  January 2021 Blue Shield Promise Medi-Cal Provider Manual Change Notification letter (PDF, 184.7KB)
  January 2021 Blue Shield Promise Nursing Facility Reference Guide Change Notification letter (PDF, 65.5KB)
  October 2020 Blue Shield Promise Medi-Cal Provider Manual Change Notification letter (PDF, 83KB)

Manuals by plan type

   Blue Shield Promise Medicare Provider Manual (PDF, 1.2MB)
  Blue Shield Promise Medi-Cal Provider Manual (PDF, 2.4 MB)
  Nursing facility reference guide (PDF, 332 KB)

 

After reviewing the manuals, complete the Acknowledgment of Blue Shield Promise Provider Manual form (PDF, 313 KB) and return it to us by fax or email:
  Fax: (323) 889-5418
  Email:ProviderRelations@blueshieldca.com

 

Additional information

 

Although the provider manuals contain comprehensive summaries of Blue Shield Promise policies and procedures, additional protocols regarding plan administrative practices, full plan medical policies, and other detailed information are available to the provider upon request by calling the Blue Shield of California Promise Health Plan Provider Services Department:

 

  Phone:(800) 468-9935, 8 a.m. to 5 p.m., Monday through Friday.

 

We'll keep you updated

 

From time to time we will need to update our website as our policies change, or as L.A. Care, Centers for Medicare & Medicaid Services (CMS), and/or Department of Health Care Services (DHCS) requirements change. We will inform you of those changes as they occur. As a Blue Shield Promise network participant, we hope you find this information helpful in understanding how Blue Shield Promise operates.