Members
Understanding your insurance
Guide to using your policy
Read our Quick Start Guide to learn the basics of using your insurance policy.
Get startedCoverage policy
Find out which procedures are covered by your policy using this search tool.
View coverageThe BlueCard® program
Make sure your healthcare needs are met when traveling or living outside of Arkansas.
View BlueCardCase management services
These services can help qualifying members navigate the healthcare system, lower costs and maximize their benefits.
Visit case managementCoverage policy and pre-certification/pre-authorization
Find out which procedures are covered by your policy or if your procedure requires prior authorization.
View coverage detailsValue-based care programs
Value-based care initiatives reward physicians for positive health outcomes and coordinating care. Find out more about programs like Patient-Centered Medical Homes (PCMH) or the Comprehensive Primary Care initiative (CPC, CPC+) and other programs using the value-based care model.
View value-based careInterQual® Coverage Policy Guidelines
The InterQual® guidelines are used by our utilization management team to help assess whether a given medical condition and known or represented circumstances of a case support medical service(s) as the most appropriate treatment, or whether the medical condition/circumstances presented could be appropriately addressed with an alternative treatment. Use the self-registration tool at the link to create a login and view the criteria. Individuals without an email address should contact the plan to receive the criteria information via mail.
View Guidelines