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Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company®, Capital Advantage Assurance Company® and Keystone Health Plan® Central. Independent licensees of the BlueCross BlueShield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies.

© 2025 Capital BlueCross All Rights Reserved.

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    1. Provider
    2. Claims and preauthorization
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    Claims and preauthorization

    Claims

    Quick tools

    • Accept/reject reports
    • Claims coding and lookup
    • eClaims view and resubmission
    • Fee schedule
    • SOR/DBR access (secure file transfer)

    Instructional materials

    • Claims coding and lookup user guide
    • CMS 1500 claim adjustments QRG
    • Federally qualified health center QRG
    • Filing an appeal QRG
    • Separately adjusted procedure codes
    • UB-04 claim adjustments

    Preauthorization

    Quick tools

    • Capital authorizations portal
    • Evicore genetic lab portal
    • Evolent cardiac and high-tech radiology portal
    • FEP Blue Standard and FEP Blue Basic preauthorization list
    • FEP Blue Focus preauthorization list
    • Pharmacy prior authorization – CoverMyMeds portal
    • Prime medical injectable portal
    • Single source preauthorization list
    • TurningPoint MSK portal

    Instructional materials

    • ProAuth user guide
    • Preauthorization training resources
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    Drug

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    Language information and resources.

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    Information

    About us

    Careers

    Code of conduct

    Developers

    Digital privacy policy

    HIPAA

    Legal

    Machine readable files - Transparency in coverage

    Media inquiries

    Nondiscrimination

    Notice of privacy practices

    Sitemap

    SMS terms of use

    Web accessibility

    Follow us

    Healthcare benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company®, Capital Advantage Assurance Company® and Keystone Health Plan® Central. Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital Blue Cross in its capacity as administrator of programs and provider relations for all companies.

    © 2025 Capital Blue Cross All Rights Reserved.

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