Manuals, Forms and Resources
Provider Manual
Entire Provider Manual including all sections:
For individual sections see below:
- Section I - Introduction (PDF)
- Section II - Quick Reference Contact List (PDF)
- Section III - Provider Roles and Responsibilities (PDF)
- Section IV - Member Rights and Responsibilities (PDF)
- Section V - Eligibility and Enrollment (PDF)
- Section VI - Covered Services (PDF)
- Section VII - Behavioral Health Services (PDF)
- Section VIII - Claim Disputes Appeals (PDF)
- Section IX - Medical Operations (PDF)
- Section X - Quality Improvement (PDF)
- Section XI - Billing Claims and Encounters (PDF)
- Section XII - Fraud Waste Abuse (PDF)