2024 AZ Blue Provider Operating Guide - Provider Newsletter December, 2023

You’re invited to preview the 2024 Blue Cross^® Blue Shield^® of Arizona (AZ Blue) Provider Operating Guide (Guide). The Guide serves as an extension of your AZ Blue participation agreement and includes helpful information for clinical, administrative, and billing teams. Please share this message with your staff.

What’s different for 2024

Below are some of the updates that will be effective January 1, 2024, unless otherwise noted. For the full list, see the 2024 Appendix of Changes.

How to access the Guide

You and your staff can view or download the Guide via the AZ Blue provider portal at “Provider Resources > Guidelines > Provider Operating Guide.” You can also find it on the homepage of the MA provider portal at azbluemedicare.com/login.

If you need help accessing the Guide or have questions about the revisions, contact your assigned Provider Relations Contact or call Provider Partnerships at 602-864-4231 or 1-800-232-2345, ext. 4231.

Note: Providers participating in the BCBSAZ Health Choice and ACA Health Choice Networks should continue to refer to provider manuals for BCBSAZ Health Choice (Medicaid and Medicare Dual SNP) and ACA StandardHealth (both published separately). Dental providers should also refer to the BlueDental^SM Provider Manual for more information about our stand-alone BlueDental plans (prefixes 99D and MUM).

In This Issue

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December news: Executive summary

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5 accepted ways to identify our members

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See our member ID prefix updates for 2024

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New program facilitates accurate coding

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Preview the 2024 Provider Op Guide

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New! Improved discounts for 90-day prescriptions

Check out this AZ resource
for promoting mental health

BlueSignature, Prosano Health, and BlueDental are service marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

Availity is a separate, independent company contracted with AZ Blue for provider portal services. Availity and Availity Essentials are registered trademarks of Availity, LLC.

OptumCare Network of Arizona (“OptumCare Arizona”) is a separate, wholly owned subsidiary of Optum and is contracted with AZ Blue to provide utilization management and claim/payment processing services for providers and attributed members with certain AZ Blue Medicare Advantage HMO plans.

The MCG care guidelines are the proprietary and copyright-protected information of MCG Health, part of the Hearst Health network.

InterQual is a registered trademark, and InterQual criteria are the proprietary and copyright-protected information, of ChangeHealthcare LLC (part of Optum) and/or one of its subsidiaries.

OptumRx is a separate, independent company that provides and is solely responsible for providing pharmacy services to AZ Blue providers and members. OptumRx does not provide AZ Blue products or services.

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