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Blue Cross NC Home Providers Network participation Resources Providers Resources

All Blue Cross and Blue Shield of North Carolina (Blue Cross NC) guidelines are based on the most current scientific evidence, and are adapted from standards published by nationally recognized authorities.

Preventive Health Guidelines

Preventive Health Guidelines are standards of care developed to encourage the appropriate provision of preventive services to patients, according to their age, gender, and risk-status. These services include screenings, immunizations and physical examinations.

Oral Health Guidelines

Source: American College of Obstetricians and Gynecologists - Oral Health Care During Pregnancy and Through the Lifespan, 2013

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Source: American Academy of Pediatrics - Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents, 2017

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Source: American Academy of Pediatric Dentistry Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents, 2013

Source: American Academy of Pediatric Dentistry - Policy on Perinatal and Infant Oral Health Care, 2016

Source: American Academy of Pediatric Dentistry - Policy on Use of Fluoride 2014

Source: American College of Obstetricians and Gynecologists, Guidelines for Perinatal Care, 8th edition
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Source: American Academy of Pediatrics, Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents, 2017
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Source: United States Preventive Services Task Force (USPSTF), Recommendations for Primary Care Practice American Academy of Family Physicians, Clinical Preventive Services Recommendations
Websites:

Sources: United States Preventive Services Task Force (USPSTF), Recommendations for Primary Care Practice American Academy of Family Physicians, Clinical Preventive Services Recommendations

Websites:

Source: Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices
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Practice Guidelines

Practice Guidelines are systematically developed statements that help practitioners make decisions about appropriate health care for specific chronic or acute clinical circumstances.

Source: National Institutes of Health National Heart, Lung, and Blood Institute-National Asthma Education and Prevention Program Expert Panel Report 3-Guidelines for the Diagnosis and Management of Asthma

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Depression Screening Tools

Source: U.S. Preventive Services Task Force (USPSTF). Screening for Depression in Adults. June 2023.

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Source: U.S. Preventive Service Task Force (USPSTF). Depression and Suicide Risk in Children and Adolescents: Screening. October 2022.

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Source: American College of Cardiology Foundation (ACCF) / American Heart Association (AHA) Guideline for the Management of Heart Failure

Source: National Institutes of Health National Heart Lung Blood Institute - Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 8)

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    Legislative resources Changes, updates and industry requirements

    Health care is a rapidly changing industry that's guided in part by legislative decisions. These decisions can sometimes affect how we conduct business together.

    The following resources can help keep you informed about legislative changes and requirements affecting health care: