Nursing facilities reference guide
This manual describes the policies and operating procedures for nursing facility providers that contract with Blue Shield of California Promise Health Plan to provide services for members. You'll need Adobe Reader to view the manual.
Change notification
January 2022 Blue Shield Promise Nursing Facility Reference Guide Change Notification letter (PDF, 173 KB)
Complete manual
January 2022 Blue Shield Promise Nursing Facility Reference Guide (PDF, 226 KB)
After reviewing the manuals, complete the Acknowledgment of Blue Shield Promise Provider Manual form (PDF, 313 KB) and return it to us by fax or email:
Fax: (323) 889-5418
Email: ProviderRelations@blueshieldca.com
Additional information
Although the provider manuals contain comprehensive summaries of Blue Shield Promise policies and procedures, additional protocols regarding plan administrative practices, full plan medical policies, and other detailed information are available to the provider upon request by calling the Blue Shield of California Promise Health Plan Provider Services Department:
Phone: (800) 468-9935, 6 a.m. to 6:30 p.m., Monday through Friday.
Access to care standards
Learn the guidelines Blue Shield of California Promise Health Plan uses to ensure our members have proper access to care.
Health assessment guidelines for Medi-Cal providers
Learn how to conduct health assessments, find age-appropriate patient questionnaires and forms, and related provider training materials.
Nursing facilities reference guide
Learn about the requirements for Blue Shield Promise's provider network nursing facilities.
Physician’s facility site review policy and procedures
See policies for site accessibility, fire safety and prevention, non-medical emergency procedures, medical equipment maintenance, and staff qualification requirements.
Medical record documentation standards
Learn about the requirements and standards for Blue Shield Promise member medical records.
Provider dispute resolution policy and procedures
Communicate your questions and concerns to Blue Shield Promise and learn how to appeal or dispute a claim payment.
Fraud prevention guidelines
Learn how to report suspected healthcare fraud and find prevention tips and guidelines.
Forms
Find the forms you need for authorizations, referrals, service requests, EFT enrollment, and provider disputes.