For Members
BCBSAZ Health Choice uses clinical practice guidelines when making important decisions about keeping you and your family healthy.
We provide the support needed to be sure your primary care provider, specialists, and other healthcare providers involved in your care work closely with you on treatment plans for individual needs.
We encourage members to call BCBSAZ Health Choice Member Services at 1-800-322-8670 with specific questions relating to your care.
Clinical Practice Guidelines and Recommendations
Adult Behavioral Health Guidelines
Tool Kit for the Management of Adult Attention-Deficit/Hyperactivity Disorder (ADHD)
Tool Kit for the Management of Adult Anxiety
Tool Kit for the Management of Adult Depression
Tool Kit for the Management of Adult Postpartum Depression
Adult Hypertention Management Guidelines (NHLBI)
Adult Obesity Management Guidelines (NHLBI and NIDDKD)
Asthma & COPD Management Guidelines (NHLBI)
Cardiac and CVA Care Management (ACC/AACE)
Childhood Behavioral Health Guidelines
Tool Kit for the Management of Childhood & Adolescent Attention-Deficit/HyperAnxiety Disorder (ADHD)Tool Kit for the Management of Childhood & Adolescent Anxiety
Tool Kit for the Management of Childhood & Adolescent Depression
Chronic Pain Management Guidelines (American Pain Society)
Diabetes Management Guidelines (ADA)
General Infectious Disease Management Guidelines (IDSA)
HIV Management Guidelines
Pediatric Obesity Management Guidelines (NHLBI and NIDDKD)
Smoking Cessation Guidelines (NIH)
Medical Determination Criteria
BCBSAZ Health Choice’s clinical and medical management teams use national guidelines and resources when making medical determinations. The resources include, but are not limited to:
- InterQual Guidelines
- CMS National Coverage Determination
- CMS Local Coverage Determination
- Hayes Knowledge Center, INC.
- UptoDate
- Plan Developed Clinical Policies
To obtain BCBSAZ Health Choice’s national and state recognized medical necessity criteria applied to behavioral health and medical decisions, please contact 1-800-322-8670 (TTY: 711).
For more information about care management at BCBSAZ Health Choice, please call:
BCBSAZ Health Choice
Toll- free: 800-322-8670
Maricopa County: 480-968-6866