Provider Resources

Provider Materials

Manuals and Forms

• 2017 Provider Manual
• 2017 Medicare Provider Manual
• Provider Information Change Form
• Prospective Provider Form

FAQs and Resources

• 2015 Tertiary Network Changes FAQ
• 2015 List of Primary and Tertiary Providers for Out-of-System Referrals
• ICD-10 FAQ

Wellness Guides

• Be Healthy Wellness Guide
• Medicare Be Healthy Wellness Guide
• WA Individual Be Healthy Wellness Guide

Digital Tools and Guides

• eviCore Resources
• YourHealthAlliance.org Provider and Office Personnel Guide
• Clear Coverage Tutorial

And check out Coding Counts for regular updates on Risk Adjustment coding and ICD-10 updates.

Medicare

• IL HMO Star Ratings Flier
• IL PPO Star Ratings Flier
• WA Star Ratings Flier
• Star Ratings Talking Points

Pharmacy

• CVS Caremark Specialty Pharmacy Services Enrollment Form

Drug Lists

• Direct Individual Plans & Employer Group Plans Standard Formulary
• Public Individual Plans & Employer Group Plans Formulary
• Specialty Drug List
• eviCore Medical Oncology Drug List

Medicare

• IL Medicare Pharmacy Directory
• IL Medicare HMO and PPO Formulary
• IA and NE Medicare HMO and PPO Formulary
• WA Medicare HMO Formulary
• High-Risk Medication Chart

Generics

• Antidepressants Comparison Guide
• ARB Antihypertension Comparison Guide
• Atypical Antipsychotics Comparison Guide
• Statin Comparison Guide

Credentialing and ePayment Forms

Credentialing Forms

For any MDs, DOs, or DCs with their primary address in Illinois:

• IL Credentialing Form

For any provider with their primary address in Iowa:

• IA Credentialing Form

For any provider except Illinois MDs, DOs, DCs, and providers in Indiana:

• Health Alliance Provider Application

Under Indiana law, Indiana providers must use the CAQH form for credentialing:

• CAQH Form

ePayment Forms

• ePayment Enrollment and Authorization Form