Provider Materials
Utilization Management
Manuals
Reimbursement Guides
Compliance Forms
Provider Addition and Change Forms
Credentialing Forms
Appeal Forms
Prior Authorization and Referral Forms
- Illinois Uniform Electronic Prior Authorization
- Substitution Code Crosswalk Table
- Provider Reference Checklist – Acute Inpatient/Mental Health/Substance Abuse
- Provider Reference Checklist – EviCore
- Provider Reference Checklist – Outpatient
- Provider Reference Checklist – Post Acute
- Provider Reference Checklist – Transplant (Admissions)
- Provider Reference Checklist – Transplant Center
- Acute Inpatient/Post Acute Authorization Request Form
ePayment Information
Provider Education Tools
Pharmacy
Forms
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- Coming Soon
High Risk Medications
Drug Lists
Formularies
Medicare
Individual and Small Group
Large Group
Tip Sheets
Quality Measure Tip Sheets
- Breast Cancer Screening
- Controlling Blood Pressure
- HbA1c Poor Control
- Colorectal Cancer Screening
- Diabetic Eye Exam
- Statin Therapy for Patients with Cardiovascular Disease
- Statin Use in Persons with Diabetes Tip Sheet
- Child and Adolescent Well-Care Visits
- Prenatal and Postpartum Care
- Exclusion Codes
- Depressive Disorder
- Diabetes Mellitus
- Coding Education
- Coding Cancer
- Code Suppression Guidelines
- Coding Flipbook
- COB Provider
- Plan All Cause Readmission
- Polypharmacy ACH
- Health Outcomes Survey