Hospital and facility guidelines manual

These guidelines describe policies and administrative procedures for Blue Shield network hospitals and facilities, including ambulatory surgery centers, behavioral health outpatient facilities, birthing centers, dialysis centers, residential treatment centers, and skilled nursing facilities. You'll need Adobe Reader to view the manual.

Change notification

January 2025 Provider Manual change notification letter (PDF, 259 KB)

 

Complete manual

January 31, 2024 hospital and facility guidelines (PDF, 4.6 MB)

Forms

Download and print commonly requested patient care, prior authorization and network forms.

Find forms for Blue Shield of California providers

Find forms for Blue Shield Promise providers

Guidelines and procedures

Find operating guidelines for clinical practices, preventive health and procedures for continuing network participation.

Read guidelines

Policies and standards

Find medication policies information and standards for HIPAA transactions, medical records and more.

Read about our policies and standards

Drugs and pharmacy resources

Search our drug formulary database, find prior authorization forms and procedures for different types of prescriptions, learn about our mail service pharmacy for medication delivery and find out about generic alternatives.

Find pharmacy resources

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