For Providers

Provider Guide — MedicareBlue PPO

Refer to the MedicareBlue PPO provider guide when you need an up-to-date resource for information on coverage, coding, billing, and reimbursement. You may download and print sections of the guide or the entire guide simply by choosing from the list below:

Entire Provider Guide (PDF) (please be aware this is a large file)
Summary of Changes (PDF)
Introduction (PDF)
Chapter 1: Contact and Administrative Information (PDF)
Chapter 2: Medical Management and Quality Improvement (PDF)
Chapter 3: Claims and Operations (PDF)
Chapter 4: Payment Methodology (PDF)
Chapter 5: Appeals (PDF)
Chapter 6: Glossary (PDF)

Medicare Advantage and Part D Compliance Training

Medicare Advantage and Part D Compliance Training (PDF)
Minnesota Attestation (PDF)
Montana Attestation (PDF)
North Dakota Attestation (PDF)
Nebraska Attestation (PDF)
Wellmark Attestation (PDF)
Wyoming Attestation (PDF)

July 04, 2009

Important Information

This page last updated and accepted by CMS June, 2009.

MedicareBlue PPO is a regional Medicare Advantage Plan with a Medicare contract. MedicareBlue Rx is a regional Medicare Prescription Drug Plan with a Medicare contract. MedicareBlue PPO or MedicareBlue Rx coverage is separately issued by one of the following plans: Wellmark Blue Cross and Blue Shield of Iowa,* Blue Cross and Blue Shield of Minnesota,* Blue Cross and Blue Shield of Montana,* Blue Cross and Blue Shield of Nebraska,* Blue Cross Blue Shield of North Dakota,* Wellmark Blue Cross and Blue Shield of South Dakota,* and Blue Cross Blue Shield of Wyoming.*

*Independent licensees of the Blue Cross and Blue Shield Association.