Documents & Forms

For your convenience, we've put these commonly used documents together in one place. Start by choosing your patient's network listed below. You'll also find news and updates for all lines of business.

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Commercial   Information icon

Administration Manuals

These manuals are your source for important information about our policies and procedures.

Authorizations & Appeals

Forms and information to help you request prior authorization or file an appeal.

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Medicare Advantage   Information icon

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Medicare with Medicaid (BlueCare PlusSM)   Information icon

Quality Care Initiatives

Information to help you maximize your performance in our quality programs.

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Medicaid (BlueCare)

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Current Lab Testing Policies

Effective 9/1/2023 through 11/1/2023
Effective 11/1/2023
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News and Updates

BlueAlert Provider Newsletter

The latest edition and archives of our monthly provider newsletter.

2024 BlueAlert Newsletter

2023 BlueAlert Newsletter

2022 BlueAlert Newsletter

2021 BlueAlert Newsletter

Quality Care Quarterly Newsletter

The latest edition and archives of our quarterly quality newsletter.

Code Edits/Code Updates

These documents contain information about upcoming code edits.

Code Archive

Bundling Rationale (Claims filed before Aug. 25, 2017)

BlueCross BlueShield of Tennessee uses a clinical editing database. The clinical editing rationale supporting this database is provided here to assist you in understanding the rationale behind certain code pairs in the database.
Code pairs reported here are updated quarterly based on the following schedule.

Date Data Effective for Source Date Change Is Applied by BCBST
January 1 April 1
April 1 July 1
July 1 October 1
October 1 January 1

These updates will be published on at least 30 days prior to the effective date of any additions, deletions or changes.