Name of Manual - Blue Cross and Blue Shield of Minnesota

Introduction
Provider Policy and
Procedure Manual
Blue Cross and
Blue Shield Plans
At Your Service
Blue Cross and Blue Shield of Minnesota developed the Provider
Policy and Procedure Manual for participating health care
providers and your business office staff. This manual provides
information about our claims filing procedures, payments, provider
agreements, managed care requirements, communications and
other topics that affect patient accounts and patient relations. As
policies and procedures change or clarification is needed, Blue
Cross will keep you updated through Provider Bulletins, Quick
Points and the Provider Press, found at bluecrossmn.com.
Information in this manual is a general outline and is part of your
provider contract. Provider and member contracts determine
benefits.
Blue Shield plans for professional services began to form across
the nation in the 1940s, after the successful Blue Cross movement
of the 1930s was well underway. Today, there are many Blue
Cross and Blue Shield Plans throughout the United States. Blue
Cross and Blue Shield Plans may be separate companies or
combined as one company. Each plan is an independent business
organization and a nonprofit independent licensee of the Blue
Cross and Blue Shield Association.
The Blue Cross and Blue Shield Association, headquartered in
Chicago, is an association of independent Blue Cross and Blue
Shield Plans. It sets performance standards and bids for national
contracts and programs. It also organizes advertising campaigns,
conducts research and coordinates legislative efforts on behalf of
the association’s members.
Blue Plus Blue Plus, an affiliate of Blue Cross, is a state-certified health
maintenance organization (HMO). In most Blue Plus products,
members select a participating primary care clinic that coordinates
all of the patient’s medical care and authorizes treatment by
specialists when necessary.
Because Blue Plus is an affiliate of Blue Cross, Blue Plus is
subject to most of the same policies and procedures. For general
information about Blue Plus, you may refer to Chapter 6 of this
manual. Blue Plus primary care clinics should refer to the Blue
Plus Provider Manual for specific Blue Plus guidelines. Blue Plus
is a nonprofit independent licensee of the Blue Cross and Blue
Shield Association.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (10/24/11) 1-3