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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements
View requirements for Local Plan and BlueCard Out-of-Area members.
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Medicare Advantage Provider FAQs
Medicare Advantage and Part D Training for Providers
Recognizing and reporting Fraud, Waste, and Abuse
Website Precertification Request Training
How to use our provider website to determine whether a service requires precertification and to submit the following requests for members
ICD-10-CM Provider Training
Coding differences for specific diagnosis between ICD-9 and ICD-10
Dual Eligible Special Needs Plan Provider Training
Understanding Dual Eligible Medicare Advantage Plans
Frequently Asked Questions
Medicare Advantage System Migration FAQ
Blue Cross and Blue Shield of Georgia moved Individual (non-group) Medicare Advantage members to a single claims processing system Jan. 1, 2015.
Where to file an appeal, time frames, who can file, MAXIMUS, and more.
Lab, DME, and Specialty Pharmacy Blue Claims
Where to file, what additional fields are required on the claims, and how to check the status of claims
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