Materiales de referencias

• 2022 Provider and Billing Manual (PDF)
  
• 2020 Provider and Billing Manual (PDF)
• 2021 Provider and Billing Manual (PDF)
  
• ICD-10 Information
• Provider Toolkit
• HEDIS MY2022 Quick Reference Guide (PDF)
• Cultural Competency Provider Training
  
• New Provider Orientation Training
  

Administración médica

• Quarter 2 2022 SB80 Report (PDF)
• Quarter 1 2022 SB80 Report (PDF)
• Pre-Auth Needed?
• Inpatient Prior Authorization Fax Form (PDF)
• Outpatient Prior Authorization Fax Form (PDF)
• Authorization and Coverage Complaints
• Provider Notification of Pregnancy Form (PDF)

Salud del comportamiento

• Discharge Consultation Form (PDF)
• OTR Completion Tip Sheet (PDF)
• Psychological or Neuropsych Testing Authorization Request Form (PDF)
• Electroconvulsive Therapy (ECT) Authorization Request Form (PDF)
• Intensive Outpatient/Day Treatment Form for Mental Health/Chemical Dependency (PDF)
• Outpatient Treatment Request Form (PDF)
• Behavioral Health HEDIS Provider Toolkit (PDF)
• Suicide Prevention (PDF)

Reclamaciones y pago de reclamaciones

• Claim Dispute Form (PDF)
• Ambetter Taxonomy Guide (PDF)
• No Surprises Act Open Negotiation Form (PDF)
  

Calidad

• Quality Improvement Program Results
• 2016 HEDIS Quick Reference Guide (PDF)
• Practice Guidelines (PDF)
• Quality Improvement (QI)

Continuity of Care Program

• Continuity of Care Booklet (PDF)
• Continuity of Care Early Submitter Bonus (PDF)

Otros

• Covered Services and Authorization Grid (PDF)
• Creating a Secure Portal Account (PDF)
• Provider Relations Territory List (PDF)