- Provider Information
- Behavioral Health
- Claims and Member Information
- Claim Reconsideration and Appeals
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete (HMO-SNP) Program
- Electronic Data Interchange (EDI)
- Pharmacy Program
- Prior Authorization & Notification
- Provider Forms
- Provider Manual
- Provider Portal
- Provider Training
- Reference Guides
- Reimbursement Policy
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.
If you have any questions about the information or material in this manual or about any of our policies or procedures, please do not hesitate to contact Provider Services at 866-331-2243.
We greatly appreciate your participation in our program and the care you provide to our members.
2018 Care Provider Manual (PDF 3.18 MB)