Reference Materials

• 2023 Provider and Billing Manual (PDF)
  
• 2022 Provider and Billing Manual (PDF)
• ICD-10 Information
• Quick Reference Guide (PDF)
• Prior Authorization Guide (PDF)
• Payspan (PDF)
• Secure Portal (PDF)
• Provider Newsletters
• Provider Network Guide (PDF)
• Home Health Filing Guidelines (PDF)

Medical Management/Behavioral Health

• Pre-Auth Needed?
• Inpatient Prior Authorization Fax Form (PDF)
• Outpatient Prior Authorization Fax Form (PDF)
• Fillable Prior Authorization Form (PDF)
• Grievance and Appeals
• Clinical Practice and Preventive Health Guidelines (PDF)
• Outpatient to ASC Prior Authorization by County (PDF)
• Discharge Consultation Form (PDF)
• SMART Goals Fact Sheet (PDF)
• ABA Prior Authorization Request Form (PDF)

Claims and Claim Payment

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

Quality

• Practices Guidelines (PDF)
• 2020 HEDIS Quick Reference Guide (PDF)
• Quality Improvement (QI)

Other

• Provider Updates
• Opioid Prescribing Limits (PDF)