Professional Provider

Education and Workshops

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

Publications

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.

Forms

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