Resources overview

We are committed to supporting you with the necessary resources to facilitate providing quality care and services to the members in our health plan.

Provider resources

Utilize our selection of resources to access frequently used forms, reference materials, provider manuals and guides, prior authorization information, clinical practice policies, and other support for delivering benefits to our members.

Forms

From office administration to patient care — our Forms page offers quick access to the documents you use the most.

Forms

Training Academy

The Training Academy offers webinars, CME courses, orientations, tutorials, and more to support providers in continuing their education.

Training Academy

Policies, guidelines, and manuals

Our provider manuals and guides provide key information and support for delivering benefits to our members.

Policies, guidelines, and manuals

Prior authorizations

Check which services require prior authorization using the Prior Authorization Lookup Tool and submit requests through Availity, fax, or phone.

Prior authorization requirements

Learn about Availity

Availity simplifies provider transactions such as prior authorization requests, electronic data exchange, claim submission and status, and member benefit and eligibility inquiries.

Learn about Availity

Medical policies and clinical guidelines

Medical Policies and Clinical Utilization Management (UM) Guidelines help us determine if a procedure is medically necessary.

Medical Policies and Clinical UM Guidelines - Coming soon

Explore more provider resources

Referrals

The Healthcare Effectiveness Data and Information Set (HEDIS®)

Patient360

Medical management model

Quality management

KanCare provider resources

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Interested in becoming a provider in the Healthy Blue network?

We look forward to working with you to provide quality service for our members.

Join our network