Resources

iLinkBlue User Guide

Professional Provider Office Manual 2025

The BlueCard^® Program Provider Manual 2025

Dental Network Provider Manual 2025

Behavioral Health

Blue Connect

Blue HPN

Community Blue

Dental Network

Eligibility and Benefits for BlueCard Members

Federal Employee Program (FEP)

HMOLA Network

HMOLA Preferred Lab

Office of Group Benefits (OGB)

Precision Blue

Preferred Care PPO Network

Preferred Care PPO Lab

Provider Self-service Guide

Registration Guide for iLinkBlue MFA

Signature Blue

Availability Standards

Medical Record Guidelines for BlueCard

Inpatient/Outpatient Authorization Guide

Medicare Crossover Claims

Identification Card Guide

Automated Benefits & Claim Status (IVR Navigation Guide)

Refund Request Guidelines for BlueCard®

A Guide for Understanding APTC Grace Periods

Submitting a Corrected Claim

HEDIS Follow-up After Hospitalization for Mental Illness

CES Tool Guide

Blue Cross Claims Confirmation Reports

Past Workshops
2025 Professional Workshop:
Session A | Session B

2024 Facility Workshop

Recent Webinars
2025 iLinkBlue Webinar

2025 BlueCard Webinar

2025 New to Louisiana Blue Webinar - Professional

2025 New to Louisiana Blue Webinar - Facility

2025 Provider Credentialing and Data Management

2024 Behavioral Health – ABA

2024 Behavioral Health – Facility

2024 Behavioral Health – Professional

2024 Genetic Testing Program Webinar

2023 Sleep Management Program Webinar

2022 New Security Setup Application Webinar

2022 Laboratory Benefit Management Program

2019 CES Webinar - Facility

2019 CES Webinar - Professional

2018 ABA WebPass Clinical Review Forms Webinar

2018 Provider Self-service Initiative Webinar

Some forms are available in DocuSign^® format only. When submitting DocuSign documents, please do not separately email them to Louisiana Blue. We automatically receive your submission from the DocuSign application. Double submissions (submitting through DocuSign and also sending an email of the completed form) could delay the processing time for your request. For details on completing DocuSign forms, see the DocuSign Guide under the Quick Links section of this page.

FORMS
Join Our Network
Professional Provider Change
Facility Change
Payment Information
Electronic Services
Authorization
Behavioral Health
Dental
Other Forms

JOIN OUR NETWORK
I am a PROFESSIONAL provider and want to start network enrollment using the LSCA packet
I am a PROFESSIONAL provider and want to start network enrollment using the CAQH packet
I need a PROFESSIONAL provider RECORD ONLY and do not wish to join the network
I am a FACILITY and want to start network enrollment
I need a FACILITY RECORD ONLY and do not wish to join the network
How does reimbursement during credentialing work?

PROFESSIONAL PROVIDER CHANGE FORMS
I need to update my PROFESSIONAL provider demographic information
I am a PRACTITIONER and need to add a location for a group/clinic I am affiliated with
I am a GROUP/CLINIC and need to add a location to existing practitioner(s)
I want to change my PROFESSIONAL GROUP/clinic Tax ID Number
I want to change my NPI
I need to link to a new group/clinic
I want to remove a location from my provider record
I want to keep my provider record but leave the network(s)
I want to terminate from a group/clinic
I want to terminate my provider record

FACILITY CHANGE FORMS
I need to update my FACILITY demographic information
I need to change my FACILITY name or DBA information
I need to add FACILITY location to an existing facility record
I want to change my FACILITY Tax ID Number
I want to change my NPI
I want to remove a facility location from my provider record
I want to terminate my provider record

PAYMENT INFORMATION FORMS
I want to receive payments via electronic funds transfer (EFT)
I need to change my electronic funds transfer (EFT) information
My patient needs to report their other insurance coverage
I have been overpaid on a claim
I want to dispute how my claim was paid

ELECTRONIC SERVICES FORMS
I want to become an Administrative Representative
I want to sign up for iLinkBlue
I want to get set up for electronic remittance advice transmissions

AUTHORIZATION FORMS
Authorization Form
Facility Admission and Recertification Form
Retrospective Review Authorization Form
Utilization Management Approval and Denial Fax Form

BEHAVIORAL FORMS
I am a behavioral health professional and want to report my areas of expertise

DENTAL FORMS
Alternative Dental Procedure Payment Responsibility

OTHER FORMS
Continuity of Care
Release of Protected Health Information Form
Itemized Bill Cover Sheet
Maternity Management Referral Form
CAA Consent Submission Form
No Surprises Act Open Negotiation Notice
OGB Bariatric Surgery Form
I need to report my professional liability case to Louisiana Blue

Effective June 1, 2025
Revised Medical Policy No. 00003 – Analysis of Human DNA or RNA in Stool Samples as a Technique for Colorectal Cancer Screening
Revised Medical Policy No. 00009 – Biventricular Pacemakers (Cardiac Resynchronization Therapy) for the Treatment of Heart Failure
Revised Medical Policy No. 00671 – ravulizumab (Ultomiris™), eculizumab (Soliris®, biosimilars)
Revised Medical Policy No. 00701 – Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia and Gastroparesis

Effective June 15, 2025
Revised Medical Policy No. 00260 – Spinal Cord and Dorsal Root Ganglion Stimulators

Effective August 1, 2025
Revised Medical Policy No. 00572 – Bioengineered Skin and Soft Tissue Substitutes
New Medical Policy No. 00926 – Peripheral Nerve Injury Repair Using Synthetic Conduits or Processed Nerve

Revised Policies

Effective for dates of service on and after January 1, 2023 to August 31, 2023:

• Policy No. G2127: Vectra DA Blood Test for Rheumatoid Arthritis

Effective for dates of service on and after January 1, 2023 to November 1, 2023:

• Policy No. G2130: ST2 Assay for Chronic Heart Failure
• Policy No. G2132: Erectile Dysfunction
• Policy No. G2133: ZIKA Virus Risk Assessment

Effective for dates of service on and after March 10, 2023 to August 31, 2023:

• Policy No. G2009: Preventive Screening in Adults
• Policy No. M2093: HIV Genotyping and Phenotyping

Effective for dates of service on and after September 1, 2023:

• Policy No. G2045: Thyroid Disease Testing
• Policy No. G2153: Pancreatic Enzyme Testing for Acute Pancreatitis
• Policy No. M2068: Testing for Alpha-1 Antitrypsin Deficiency
• Policy No. M2097: Identification of Microorganisms using Nucleic Acid Probes

Effective for dates of service on and after October 1, 2023:

• Policy No. G2149: Pathogen Panel Testing
• Effective for dates of service on and after November 1, 2023:

• Policy No. G2158: Testing for Vector-Borne Infections

Effective for dates of service on and after January 1, 2024:

• Policy No. G2155: General Inflammation Testing

Effective for dates of service on and after May 1, 2024:

• Policy No. G2005: Vitamin D Testing
• Policy No. G2006: Diabetes Mellitus Testing
• Policy No. G2011: Diagnostic Testing of Iron Homeostasis & Metabolism
• Policy No. G2013: Testosterone
• Policy No. G2014: Vitamin B12 and Methylmalonic Acid Testing
• Policy No. G2036: Hepatitis Testing
• Policy No. G2098: Immune Cell Function Assay
• Policy No. G2110: Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease
• Policy No. G2157: Diagnostic Testing of Common Sexually Transmitted Infections
• Policy No. G2174: Coronavirus Testing in the Outpatient Setting
• Policy No. M2141: Testing of Homocysteine Metabolism-Related Conditions
• Policy No. P2018: Immunohistochemistry

Effective for dates of service on and after July 1, 2024:

• Policy No. M2176: Testing for Autism Spectrum Disorder and Developmental Delay
• Policy No. R2162: Laboratory Procedures Reimbursement Policy

Effective for dates of service on and after October 1, 2024:

• Policy No. G2031: Allergen Testing
• Policy No. G2056: Diagnosis of Idiopathic Environmental Intolerance
  
• Policy No. G2099: Intracellular Micronutrient Analysis
• Policy No. G2120: Salivary Hormone Testing
• Policy No. G2125: Urinary Tumor Markers for Bladder Cancer
• Policy No. G2138: Evaluation of Dry Eyes
• Policy No. G2143: Lyme Disease Testing
• Policy No. G2181: Colorectal Cancer Screening
• Policy No. M2172: Onychomycosis Testing
• Policy T2015: Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Effective for dates of service on and after January 1, 2025:

• Policy No. F2019: Flow Cytometry
• Policy No. G2002: Cervical Cancer Screening
• Policy No. G2007: Prostate Biopsy Specimen Analysis
• Policy No. G2035: Prenatal Screening (Nongenetic)
• Policy No. G2043: Celiac Disease Testing
• Policy No. G2048: Biochemical Markers of Alzheimer Disease and Dementia
• Policy No. G2050: Cardiovascular Disease Risk Assessment
• Policy No. G2051: Bone Turnover Markers Testing
• Policy No. G2059: Epithelial Cell Cytology in Breast Cancer Risk Assessment
• Policy No. G2060: Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing
• Policy No. G2061: Fecal Calprotectin Testing in Adults
• Policy No. G2063: Testing for Diagnosis of Active or Latent Tuberculosis
• Policy No. G2100: In Vitro Chemoresistance and Chemosensitivity Assays
• Policy No. G2105: Immunopharmacologic Monitoring of Therapeutic Serum Antibodies
• Policy No. G2107: Measurement of Thromboxane Metabolites for ASA Resistance
• Policy No. G2113: Oral Cancer Screening and Testing
• Policy No. G2119: Diagnostic Testing of Influenza
• Policy No. G2121: Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease
• Policy No. G2123: Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases
• Policy No. G2124: Serum Tumor Markers for Malignancies
• Policy No. G2150: Biomarkers for Myocardial Infarction and Chronic Heart Failure
• Policy No. G2154: Folate Testing
• Policy No. G2156: Urine Culture Testing for Bacteria
• Policy No. G2159: B-Hemolytic Streptococcus Testing
• Policy No. G2173: Gamma-glutamyl Transferase Testing in Adults
• Policy No. M2041: Venous and Arterial Thrombosis Risk Testing
• Policy No. M2112: Nerve Fiber Density Testing

Effective for dates of service on and after March 15, 2025:

• Policy No. G2036 – Hepatitis Testing
• Policy No. G2045 – Thyroid Disease Testing
• Policy No. G2110 – Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease
• Policy No. G2149 – Pathogen Panel Testing
• Policy No. G2153 – Pancreatic Enzyme Testing for Acute Pancreatitis
• Policy No. G2155 – General Inflammation Testing
• Policy No. G2157 – Diagnostic Testing of Common Sexually Transmitted Infections
• Policy No. G2158 – Testing for Vector-Borne Infections
• Policy No. M2068 – Testing for Alpha-1 Antitrypsin Deficiency
• Policy No. M2097 – Identification of Microorganisms using Nucleic Acid Probes

Effective for dates of service on and after June 1, 2025:

• Policy No. G2005: Vitamin D Testing
• Policy No. G2011: Diagnostic Testing of Iron Homeostasis & Metabolism
• Policy No. G2014: Vitamin B12 and Methylmalonic Acid Testing
• Policy No. G2174: Coronavirus Testing in the Outpatient Setting

Effective for dates of service on and after September 1, 2025:

• Policy No. G2008: Prostate Specific Antigen (PSA) Testing
• Policy No. G2022: Biomarker Testing for Autoimmune Rheumatic Disease
• Policy No. G2042: Pediatric Preventive Screening
• Policy No. G2044: Helicobacter Pylori Testing
• Policy No. G2164: Parathyroid Hormone, Phosphorus, Calcium and Magnesium Testing
• Policy No. M2057: Diagnosis of Vaginitis
• Policy No. M2116: Human Immunodeficiency Virus (HIV)
• Policy No. M2172: Onychomycosis Testing

New Policies
Effective for dates of service on and after March 1, 2024:

• Policy No. G2043 - Celiac Disease Testing
• Policy No. G2051 - Bone Turnover Markers Testing
• Policy No. G2059 - Epithelial Cell Cytology in Breast Cancer Risk Assessment
• Policy No. G2157 – Diagnostic Testing of Common Sexually Transmitted Infections
• Policy No. G2159 - B-Hemolytic Streptococcus Testing

Effective for dates of service on and after March 15, 2025:

• Policy No. G2151 – Serum Testing for Evidence of Mild Traumatic Brain Injury

Effective for dates of service on and after June 1, 2025:

• Policy No. M2067: Therapeutic Drug Monitoring for 5-Fluorouracil

Humira Biosimilar Coverage Overview