Provider manuals and guides
Healthy Blue is committed to supporting you in providing quality care and services to the members in our network. Here you will find information for assessing coverage options, guidelines for clinical Utilization Management (UM), practice policies and support for delivering benefits to our members.
Provider manuals
The Healthy Blue Medicaid Managed Care Provider Manual provides key administrative information, including the quality improvement program, the UM program, quality standards for participation, claims appeals, and reimbursement and administration policies.
Documents
Medical policies and clinical UM guidelines
Medical policy addresses the medical necessity of new services or procedures and new applications of existing services or procedures. Clinical UM guidelines focus on detailed selection criteria, goal length of stay and location for generally accepted technologies or services.
Join the Healthy Blue Dual Advantage (D-SNP) network
Our prior authorization, referrals, claims, and payment processes are streamlined to help you focus on what you do best — caring for your patients.
Additional resources
- Louisiana Department of Health
- Think Cultural Health
- National CLAS Standards
- LDH Minority Health – Cultural Competence
- My Diverse Patients website
- What Matters Most: Improving the Patient Experience
- Moving Toward Equity in Asthma Care
- American Health Information Management Association
- National Suicide Prevention Lifeline at 1-800-273-TALK (8255)
- American Foundation for Suicide Prevention
- American Association of Suicidology
- National Alliance on Mental Illness at 225-291-6262
- Gambling Treatment Providers
- QUIT WITH US, LA at 1-800-QUIT-NOW
Documents
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Referrals
- Forms
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)