Close Table of Contents Contact Information Member Eligibility Disenrollment Requests Billing/Claims Provider Appeals Pharmacy Utilization Management Preferred Providers PCP Services Credentialing Quality Improvement Compliance Updates Medicare   Provider Manual Credentialing Who should be credentialed? Documents required for credentialing Credentialing Application Practitioner Appeal Rights Request for a Hearing Standard Practitioner Application - Attachment A Ambulatory Site Review - Attachment B Quality Improvement *Note: Due to the size of the above file, it may take a few minutes to download. NCQA overview HIPAA Release Information HEDIS Summary HEDIS Information Sheet Medical Record Keeping Member Complaints Clinical Practice Guidelines QI Resources EPSDT Immunization Schedule Preventive Health Guidelines Maternal Child Health Program Disease Management Compliance Fraud and Abuse HIPAA Deficit Reduction Act (DRA) Updates None Medicare None   << Previous   - You will need Adobe Acrobat Reader in order to view the Provider Manual. If you do not have Adobe Acrobat Reader installed on your computer, click on the Adobe Acrobat Reader button below to download a free copy.   return to top

Last Updated 07/20/2007