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Professional Provider


Education & Workshops
Training workshops at locations throughout the state, web-based educational modules and webinars.

Newsletters, manuals, credentialing information, policy memos and other helpful information.

Medical Policies
A list of Medical Policies, articles by Medical Review Staff and Experimental/Investigational services.

Quality-Based Reimbursement Program
Detailed information regarding QBRP, a program designed to monetarily reward providers for quality.

Precertification / Prior Authorization
A resource for determining member coverage before performing services or prescribing medication.

Preventive Services Guidelines
A guide to preventive services available.

Electronic prior authorization for prescribers and pharmacists.

EFT, OPL, CAQH, Predetermination Requests and many other helpful forms.

Latest News
A list of eNews notifications.

Sign up for email notifications regarding news and updates.