Welcome Provider!
Blue Cross and Blue Shield of Illinois
   
gray line
Print Page
Fast Path
Provider Library
BlueCard Program
BlueChoice/BlueChoice Select Reference Material*
Blue Medicare Private Fee-for-Service Terms and Condition
Blue Review
CMS-1500 (08/05) Claims Filing Instructions Revised (05/08)
Draft Medical Policies New
Forms
HIPAA Notice of Privacy Practices
HMO Resources*
Interactive Voice Response System (IVR)
Manuals*
Medical Policies
Medicare Supplement Benefit Matrices New: 2008 Benefits
Physician's Advisory Committee
Privacy Statement
Professional Provider Network Consultant List
Provider Network Consultant List (Ancillary Providers)
Reference Guides
Refund/Payment Recovery Program
UB-04 Claims Filing Instructions Revised (05/08)
*Requires password for entry

Click Here to Update Provider Information

Forms
Provider Library Forms
 
Form Name
File Size
Behavioral Health Release of Information Form - Sample 17 KB
  BlueChoice Referral Form 35 KB
  CMS-1500 User Guide (NPI-only Version) - Revised (05/08) 220 KB
  COB Questionaire 35 KB
  Fee Schedule Request - BlueChoice 31 KB
  Fee Schedule Request - PPO 31 KB
  Immunoglobulin Therapy Request Form 28 KB
  IVR Benefit Sheet 68 KB
  Lupron Depot Checklist 116 KB
PAVET™ Evaluation for Microprocessor Knee  103 KB
  Predetermination Request Fax Form 28 KB
  Provider File Update Form 20 KB
  Provider Review Form 78 KB
  Provider Voluntary Refund Form 16 KB
Standard Authorization Form to Use or Disclose PHI 33 KB
  UPP Refund Portal Authorization Form 119 KB
  Voucher Request Form 18 KB
  Wheelchair Medical Necessity and Home Evaluation Verification Form 24 KB

Blue Review
October 2008 Issue
Check the Archives

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
© Copyright 2008. Health Care Service Corporation. All Rights Reserved.

Home | Important Information