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2011 Provider Manual

View complete 2011 Provider Manual (.pdf)

2010 Provider Manual Chapters

  1. Introduction (.pdf)
  2. Rights and Responsibilities of Physicians and Providers (.pdf)
  3. Provider Services (.pdf)
  4. Provider Billing (.pdf)
  5. Credentialing (.pdf)
  6. Medical Management (.pdf)
  7. Clinical Practice Guidelines (.pdf)
  8. Fraud and Abuse (.pdf)
  9. Complaint Reporting (.pdf)
  10. Community Care Connector (.pdf)
  11. Joint Powers Board (.pdf)
  12. Member Services (.pdf)
  13. Member Eligibility (.pdf)
  14. Member Sample ID Cards (.pdf)
  15. Member Grievances and Appeals Process for Medicaid Programs (.pdf)
  16. Restricted Recipient Program (.pdf)
  17. Wellness Programs (.pdf)
  18. Child and Teen CheckUp Programs (.pdf)
  19. Chiropractic Services (.pdf)
  20. Dental Services (.pdf)
  21. Pharmacy Services (.pdf)
  22. Chemical Health Services (.pdf)
  23. Mental Health Services (.pdf)
  24. Home Health Care Services (.pdf)
  25. Eyeglasses and Vision Care Services (.pdf)
  26. Interpreter Services (.pdf)
  27. Non-Emergency Transportation Services (.pdf)
  28. Critical Access Hospital (.pdf)
  29. Rural Health Clinic (.pdf)
  30. Nursing Facility (.pdf)

Provider Resources

Quick Reference Phone Numbers

Claims

Credentialing

Provider Manual

Provider Directory (.pdf)

Forms

Policies

Sample ID Cards

Pharmacy Info

Prior Authorization & Notification List

Disease Management & Chronic Care Improvement Programs

Chemical Dependency

Provider Updates & Network News

Questions & Answers