Forms & publications for healthcare providers

Find documents including forms, provider publications, how-to-guides and e-commerce specifications. 

Provider demographic updates and contracting forms

Prior authorization

Product/network guides

 

Select “Date” or “Name” below to sort.

Date Name
01/08/2020 QP5-20 Pharmacy Benefit Exclusions
01/08/2020 QP6-20 Separate Remits Will be Sent for Processed Legacy Platform Runout Claims
01/08/2020 QP3-20 Addition of Mille Lacs Corporate Ventures to the American Indian Tribal Fee Schedule for Eligible Facility and Professional Services Provided to Purchased/Referred Care (PRC) – Eligible American Indians
01/08/2020 QP7-20 Pharmacy Benefit Exclusion for Vyondys 53 (golodirsen)
01/08/2020 QP8-20 Medical Drug Update for New to Market Golodirsen (Vyondys 53)
01/08/2020 QP4-20 Minnesota Health Care Programs (MHCP) and Minnesota Senior Health Options (MSHO) Behavioral Health Fax Back Notification Update
01/08/2020 QP1-20 Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) Criteria: Palforzia and Viaskin Peanut (Peanut Allery Oral Immunotherapy)
01/02/2020 P4-20 Lab Management Clinical Guideline Updates for Fully Insured Commercial and Medicare Advantage Subscribers – eviCore Healthcare Specialty Utilization Management (UM) Program
01/02/2020 P2-20 Radiation Oncology Program Updates for Fully Insured Commercial and Medicare Advantage Subscribers – eviCore Healthcare Specialty Utilization Management (UM) Program
01/02/2020 P6-20 Sleep Management Clinical Guideline Updates for Fully Insured Commercial and Medicare Advantage Subscribers – eviCore Healthcare Specialty Utilization Management (UM) Program

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