Provider Forms & Policies
For Mississippi Network Providers
Forms
Contraceptive Coverage Exception requests must be submitted through the Be RxSmart section in your myBlue Provider account.
View our Electronic Solutions page to learn about setting up electronic submission, resolving common errors and claim reject reasons.
Provider Administration Update Forms
Inform us about changes in Provider information by submitting the applicable form below.
Policies
Medical Policy is used by BCBSMS as one set of guidelines to assist BCBSMS in making benefit coverage decisions.
BCBSMS follows CPT, HCPCS and ICD-10-CM national coding guidelines.
Click to view our library of Healthy You! procedure and diagnosis codes.
Learn more about the Healthy You! wellness benefit.
Click the link above to read the BCBSMS Transplant Travel and Lodging Reimbursement Policy.
For Out-of-State and Non-Network Providers
Reference for information on how the No Surprises Act protects consumers from surprise billing and impacts the process of payments.
Online Authorization Forms
- Submit an Outpatient and Professional Services Authorization Request
- Submit a Mental Health and Substance Abuse Authorization Request
- Submit a Prescription Drug Prior Authorization Request
- Submit a Prescription Drug Prior Authorization Appeal
- Submit a Home Infusion Therapy Request Form
- Submit a Home Health & Hospice Authorization Request Form
- Submit a Transplant Prior Authorization Request
Inpatient Care Coordination Forms
- Submit Hospital Inpatient Care Coordination Information
- Submit Continued Stay or Discharge Care Coordination Information