Referral Forms:
- Ceresti:BCBS_Ceresti-IntakeForm_8-1-24 (PDF)
- Corner Home Medical 2025: 2025 BLUE PLUS MSHO SUP BENEFITS REFERRAL FORM CHM12-13-24 (DOCX)
- Dose Flip: Dose-BCBS referral form 12.15.22 (PDF) https://app.dosehealth.com/referrals
- NourishedRx 2025: 2025 BCBS MN_NourishedRx_MSHO Referral Form (DOCX)
- QMedic 2025 QMedic Referral Form – BCBS MN 2025 (PDF)
- SafetyBenefit: InHomeSafetyBenefit_ReferralForm_BluePlus (DOCX)
Provider materials:
Alliance:
- M06011R02_MSHO Music Therapy DHS Approved CMS Accepted (PDF)
- AMT Music Therapy 2023 (PDF)
- BCBS-Alliance Music Therapy Handout (PDF)
BlueRide
Ceresti
- Ceresti_BCBS_Flyer 6-20-23 DHS Approved CMS Accepted (PDF)
- Ceresti_Caregiver_Letter_6-16-23 DHS Approved CMS Accepted (PDF)
- Ceresti_Mbr_Letter_6-16-23 DHS Approved CMS Accepted (PDF)
- Ceresti Caregiver Letter_DHS Approved 10-24 (PDF)
- Ceresti Member Letter_DHS Approved 10-24 (PDF)
CVS Catalog
Template for submitting multiple CVS OTC orders – BCBSMN_updated 2-28-25 (XLSX)
Dose Health
- Dose Health Services Flyer (PDF)
- Dose Health Client Tri Fold (PDF)
- Training Dose Flip Slides for BCBS MSHO Training (PDF)
Juniper:
- H2425_032222O05 Juniper_BCBS insert – rev6622 (PDF)
- Juniper Program Descriptions (PDF)
- Juniper brochure GENERAL-11-22-FINAL (PDF)
- Juniper Quick Guide for Care Coordinators (PDF)
LSS:
- Companion_Services___LSS_Healthy_Transitions_Flyer_Final (PDF)
- LSS_PD-CommunityCompanion-Training-Slides (PDF)
NourishedRx
- NourishedRx_BCBSMN MSHO Benefit_One Pager_2023.12.20 (PDF)
- NourishedRx MSHO Letter Final DHS Approved (PDF)
- BCBS MN MSHO – NRx Program 1-Pager (2025)_2024.08.12_for Care Coordinators (PDF)
PayForward
QMedic:
2025
- QMedic – Watch Band Options (PDF)
- QMedic – VRA (PDF)
- QMedic – New Mobile Wrist (PDF)
- QMedic – Mobile Watch 2024 (PDF)
- QMedic – Free Add Ons (PDF)
- QMedic – Did You Know – Bilingual (PDF)
- QMedic – Device Hardware Chart (PDF)
- QMedic – Companion Pet (PDF)
- QMedic – Blood Pressure Monitor 2024 (PDF)
- MSHO-QMedic-Resource-2025 (PDF)
SilverSneakers+
- SilverSneakers Member Virtual Orientation Flyer – Central time (PDF)
- H2425_23_3002538_U_SilverSneakers Flyer (PDF)
- H2425_22_3001767_U MSHO SilverSneakers Fitness at Home Brochure (PDF)
- CC Guide-SILVERSNEAKERS ID NUMBER FOR MEMBERS BCBSMN (PDF)
- Silver Sneakers Care Coordination Talking Points for Steps (PDF)
Instruction Sheets:
2025 Household Supports Flex Card Benefit Instruction Sheet_2-4-25 (PDF)
Other:
- Interacting with Pets: InteractingWithPets-Member (PDF)
- Podiatry: Podiatry Benefit (PDF)
- Safety benefit resource: $750 Saftey Benefit 1-31-24 (PDF)
- Vision quick point: QP17-23-FINAL-Enhanced-Benefit-Eyewear-SecureBlue-MSHO (PDF)