Clinical policies, procedures, and guidelines

Learn about our policies, requirements, criteria for evaluating and applying new technologies, and procedures that comprise our medical care solutions:

  • Medical policies and guidelines
  • Medical care solutions
  • Prior authorization list
  • Prior authorization and referral forms
  • Pharmacy services information and drug formularies

Medical care solutions

Review medical care solutions for Blue Shield Promise plans.

Prior authorization list

View the list of medical services and procedures requiring medical necessity review or supplemental documentation prior to payment.

Clinical practice guidelines and shared decision-making aids

Clinical practice guidelines define healthcare standards applicable to members and providers.

Pharmacy services and drug formularies

Access drug formularies and find pharmacy services information.

Policies, guidelines, standards and forms

Find provider manuals, provider dispute resolution policies, medical record, access to care standards, and more.

Prior authorization and referral forms

Find common forms which you may need to request prior authorization, as well as patient referral forms.

Provider Connection

Access network provider tools on Provider Connection website.

Health Care Options: (844) 580-7272  {TTY: {800) 430-7077}, Monday through Friday from 8 a.m. — 6 p.m. 

For information on Blue Shield Promise plans for your health care, call the Department of Health Care Services at (800) 430-4263 {TTY: (800) 735-2922}, or visit https://www.healthcareoptions.dhcs.ca.gov/.

Blue Shield of California Promise Health Plan is a managed care organization, wholly owned by Blue Shield of California, offering Medi-Cal Plans.

© 2002-2024. California Physicians’ Service DBA Blue Shield of California Promise Health Plan. All rights reserved.

California Physicians’ Service DBA Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association.

The provider network may change at any time. You will receive notice when necessary.

Blue Shield of California Promise Health Plan complies with applicable state laws and federal civil rights laws, and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability.

Blue Shield of California Promise Health Plan cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, país de origen, ascedencial, religión, sexo, estado civil, genero, identidad de genero, orientación sexual, edad ni discapacidad.

Blue Shield of California Promise Health Plan遵循適用的州法律和聯邦公民權利法律,並且不以種族、膚色、原國籍、血統、宗教、性別、婚姻 狀況、性別認同、性取向、年齡或殘障為由而進行歧視。

 

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Blue Shield of California Promise Health Plan, 3840 Kilroy Airport Way, 
Long Beach, CA  90806

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