Learn about our policies, requirements, criteria for evaluating and applying new technologies, and procedures that comprise our medical care solutions:
- Blue Shield Promise Medical policies
- Clinical Policies and Procedures
- Prior authorization list
- Prior authorization and referral forms
- Pharmacy services information and drug formularies
Review medical care solutions for Blue Shield Promise plans.
Use these medical policies to provide Blue Shield Promise Medi-Cal plan members with the highest standard of evidence-based medical care that is safe and effective.
View the list of medical services and procedures requiring medical necessity review or supplemental documentation prior to payment.
Clinical practice guidelines define healthcare standards applicable to members and providers.
Access drug formularies and find pharmacy services information.
Find provider manuals, provider dispute resolution policies, medical record, access to care standards, and more.
Find common forms you may need for authorizations, patient referrals, and more.
Visit this page to find Blue Shield of California Promise Health Plan payment policies applicable to claims for our Medi-Cal plan members.