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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

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Blue Cross and Blue Shield of Georgia Clinician Tools and Resources

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This Blue Cross and Blue Shield of Georgia (BCBSGA) website provides up-to-date information, tools and resources for providers.  
 
BCBSGA Links  
BCBSGA Provider Home –BCBSGA home page especially designed for use by all of our providers. 
BCBSGA Medicare Advantage Provider Home - Landing page for our Medicare Advantage providers. 
Availity - One Stop Shopping’ for Providers to conduct transactions and exchange information with many payers through a common portal.  
Click Here to contact Case Management and Condition Care Management Provider Referrals.  
Frequently Used CPTII Codes - use CPTII codes for Medicare Advantage claims to help ensure timely and accurate payments. 
 
External Documents 
Click Here to access our library of educational documents for physicians and practitioners.  
 
Pharmacy 
We recognize the importance of Beers Criteria for potentially inappropriate medication use in older adults. Consider drug alternatives when appropriate in prescribing high risk medications in older adults.  
High Risk Medications in Older Adults: Drug Alternative(s)
 
External Links  
Colorectal Cancer Testing
Mammograms
Cancer Prevention Guidelines
 
Patient Guides
Health Literacy Programs
 
Health Literacy Programs
 
DMARDs
 
Health Literacy Training
Preventing Chronic Disease Newsletter Archive
 
Health Risk Assessments and Modes of Provisions for Medicare Beneficiaries
Outreach and Education
Tools
 
Go 4 Life Patient Materials
 
Men’s Health Materials
Women’s Heath Materials
 
AskMe3

Patient Materials

 
Health promotion and Disease Prevention
Rand Research on Health Behavior and Lifestyle Change
Quality Indicators – ACOVE 3
 
Aging and Primary Care
Health Topics
 
BCBSGA Newsletter  
Georgia Newsletter - Collection of provider newsletters focusing on Georgia 
© 2014 BlueCross BlueShield of Georgia
Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.