MCG Implementation of Cite for Care Guideline Transparency

July 1, 2022, Update: This communication has been updated to change the effective date from May 18, 2022, to July 1, 2022.

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has partnered with Milliman Clinical Guidelines (MCG) Health to implement Cite for Care Guideline Transparency. Effective July 1, 2022, our medical policies will be located in the Blue E provider portal. A list of Blue Cross NC medical policies will still be shown on the public Blue Cross NC website, but upon clicking the link of a specific medical policy, providers will be redirected to Blue E and asked to log in.  

By utilizing MCG for Cite Guideline Transparency, Blue Cross NC can share clinical indications with providers. The tool operates as a secure extension of Blue Cross NC’s existing MCG investment and helps meet regulations related to transparency for care delivery. Additional benefits include: 

• Delivering industry-leading medical determination transparency.  
• Accessing MCG clinical evidence that payers use to support member care decisions.  
• Ensuring easy and flexible access via secure web access. 

This effort is the first in a phased initiative to launch an advanced provider prior-authorization self-service platform coming later this year.  

MCG Cite for Care Guideline Transparency will not affect the process for notifying Blue Cross NC of admissions or for seeking Prior Authorization approval.