Please use this section to print forms, access guidelines, and review our business practices.

Events

• EFT Service with PaySpan Health

 Utilization Management

• ED Hospital Claim Review Process – Revised 100609
• Hospital to Hospital Back Transfer Policy (PDF)
• Prior Authorization Guide – Updated 01/2010

 General Information

• ARQ Physicians Injectable List (PDF)
• 2008 Child and Adolescent Immunization Schedule Update (PDF)
• Claims Submission Time Frames (PDF)
• Cultural Competency Strategic Plan (PDF)
• Participating Ambulatory Surgical Centers (PDF)
• Payment EX CODES (PDF) – 2009
• Provider Appeal Process – October 2008 (PDF)
• Provider Solutions Department _ Territory Listing (PDF)
• Provider Stat Lab List (PDF) – Updated 03/2010
• Provider Quick Reference Guide – Updated 05/2010 (PDF)
• Vaccine for Children Program (PDF)

Billing Guides

• New Billing Requirements Guide (PDF)
• Health Check EPSDT Tips and Reminders (PDF)
• Facility Claims – UB 04 (PDF)
• FQHC/RHC Billing Tips
• FQHC/RHC Health Check Billing Reminders (PDF)
• Physician Claims – CMS 1500 (PDF)
• Provider Watch – Billing Guidelines 2008 (PDF)

HEDIS Tip Sheets – KeyFactors to Consider

• HEDIS TipSheets (PDF)