Provider Secured Services

Medicare resources

• CMS website
  • Medicare Learning Network
  • CMS manuals
  • CMS transmittals
  • CMS Quarterly Provider Update
  • CMS HIPAA website
• Medicare glossary

Plan basics

• Medicare Plus Blue PPO manual (PDF)
• MA PPO contract documents
• Medicare Advantage library

Coverage details

• Benefit summaries
• Enhanced benefits
• DME coverage
• Medicare Advantage PPO lab network
• Specialty care
• Drugs, drug plans and vaccines

Billing & payment

• Eligibility and coverage
• Billing members
• Submitting claims
• Overpayment
• Reimbursement
• Claims questions and appeals
• If you don't participate with Medicare

Evaluation and management

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• Hospice care

Overview & resources

• Other Blue plans (PDF)
• Contact information
• ID card
• FAQs
• CMS Quality Star Ratings program
• Health e-Blue^SM
• Healthy Advantage Rewards
• Fraud, waste and abuse training
• Medicare guidelines
• Medicare resources
• Types of products
• Glossary
• Site map

Evaluation and management

• Hospice care

Care management

• Prior notification and utilization management
• Care management