Blue Shield of California
Welcome to the Blue Shield of California page. Here you can access helpful information related to the program.
To support the benefit change that is being implemented for many of your PPO patients Blue Shield of CA and NIA are educating providers about facility options available for the delivery of advanced imaging diagnostic services ordered. NIA will provide information to providers if the facility selected could result in a higher out of pocket cost to the patient. NIA will assist the provider in selecting an alternate facility that best meets their patient needs. If you have any questions regarding this program please contact Joseph Safran, Blue Shield of California Sr. Network Manager of Ancillary and Specialty Networks, at (916) 350-7619.
- Blue Shield of CA Requests for Authorizations and Appeals (PDF 26K)
- Blue Shield of CA Utilization Review Matrix - 2019
- RadMD Quick Reference Guide
- RadMD for Ordering and Imaging Providers
- RadMD Upload Feature
- RadMD Ordering Provider Access
Musculoskeletal Care Management
Blue Shield of California has implemented a Musculoskeletal program that includes spine surgery and interventional pain management for Blue Shield PPO plan members. The program will include dates of service on and after January 1, 2017.
- BSCA Utilization Matrix - 2019
- BSCA Frequently Asked Questions
- BSCA Provider Training PPT
- BSCA Combo Announcement Letter
- BSCA RadMD Pain Management Injection Quick Reference Guide
- BSCA RadMD Pain Management Surgery Quick Reference Guide
- Clinical Guidelines
Refer to the Utilization Review Matrix document to view specific codes managed by NIA