- Provider Information
- Billing and Reference Guides
- Claim Reconsideration and Appeals
- Claims and Member Information
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete (HMO-SNP) Program
- Electronic Data Interchange (EDI)
- Pharmacy Program
- Provider Administrative Manual
- Provider Forms
- Provider Training
- Reimbursement Policy
Provider Administrative Manual
The Provider Manual is designed as a comprehensive reference for information you and your staff need to conduct your transactions with us in the quickest and most efficient manner possible. Much of this material, as well as operational policies and additional information, is available on this site.
Our goal is to help ensure that our members have convenient access to high-quality care provided according to the most current and efficacious treatment protocols available. We are committed to working with and supporting you and your staff to achieve the best possible health outcomes for our members.
We greatly appreciate your participation in our program and the care you provide to our members.
The most recent version of our Provider Manual is listed below.
Physician, Health Care Professional, Facility and Ancillary Provider Manual (PDF 751.54 KB) - Updated 6.19.2017