Policies and guidelines
Operations management
Medical policy
Use this online searchable database to read Independence Blue Cross medical and claim payment policies.
Precertification and cost-share requirements
Learn what services require preapproval/precertification from Independence prior to being performed.
Dosage and Frequency Program
Learn how Independence reviews treatment regimens for certain specialty drugs to ensure they adhere to safe prescribing limits.
Most Cost-effective Setting Program
Find out how Independence reviews the requested treatment settings for certain specialty drugs that are eligible for coverage under the medical benefit.
Medical policy/precertification inquiry
Use this electronic form to look up medical policy or preapproval/precertification information for out-of-area Blue plan members.
Pre-service review for out-of-area members
Use PEAR Practice Management on the Provider Engagement, Analytics & Reporting (PEAR) portal to request electronic pre-service reviews for out-of-area members by accessing the provider portal of the member’s Home Plan.
Pharmacy information
Drug formularies
Learn more about the various drug formularies offered to Independence Blue Cross members, and search for covered drugs.
Prior authorization
Read about our prior authorization requirements for certain covered drugs.
Pharmacy policies
Find Independence Blue Cross pharmacy policies related to specific pharmaceutical agents.
Blood glucose meter
Find out how your patients can get free blood glucose meters to help them manage diabetes.
Specialty medical drugs
Understand what constitutes a specialty medical benefit drug and view a complete list of those covered under the member’s medical benefit.
Direct Ship Drug Program
This program allows in-network providers to order select specialty medical benefit drugs for administration in the office.