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The files below are in PDF format.
October 2024
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December 2023
November 2023
October 2023
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January 2023
December 2022
November 2022
October 2022
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January 2022
December 2021
November 2021
October 2021
September 2021
August 2021
July 2021
June 2021
May 2021
April 2021
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January 2021
Prior Authorizations Pre-Service Review Guide & Request Forms
Home Health and Outpatient Therapy Prior Authorization Form
Pharmacy Prior Authorization Form
2024 Q4 Prior Authorization Codification List
2024 Q4 Prior Authorization Codes Discontinued
Prior Authorization Codification List - 2024 - Q3
Prior Authorization Codification List - 2024 - Q2
Prior Authorization Codification List - 2024 - Q1
Prior Authorization Codification List - 2023 - Q4
Prior Authorization Codification List - 2023 - Q3
Prior Authorization Codification List - 2023 - Q2
Prior Authorization Codification List - 2023 - Q1
Prior Authorization Codification List - 2022 - Q4
Prior Authorization Codification List - 2022 - Q3
Prior Authorization Codification List - 2022 - Q2
Prior Authorization Codification List - 2022 - Q1
Prior Authorization Codification List - 2021 - Q4
Prior Authorization Codification List - 2021 - Q3
Prior Authorization Codification List - 2021 - Q2
Prior Authorization Codification List - 2021 - Q1
Prior Authorization Codification List - 2020 - Q4
Prior Authorization Codification List - 2020 - Q3
Prior Authorization Codification List - 2020 - Q2
Prior Authorization Codification List - 2020 - Q1
Illinois Hospital Health Care System Service Area Map
Illinois Service Area - Ancillary
Illinois FQHCs, RHCs, and ERCs
Molina Authorized Representative Designation Form
Molina Claim-Issue Template (download)
CAQH Form
CAQH Quick Reference Guide
Claims Dispute Request Form
Health Delivery Organization (HDO) Form
Patient Change of Address Form
Pregnancy Notification Form
Provider Contract Request Form
Provider Information Update Form
Provider Memo: Change Healthcare/ECHO Health Payment Option
Provider Profile and EFT Registration Form
Request to Change PCP Form
Supplier Setup Form (atypical providers)
Universal IAMHP Roster Template (download)
Universal IAMHP Roster Training
W-9 Form (irs.gov)
2023 Medicaid Redetermination FAQ
Availity - How To Open a Support Ticket
Availity Appeal a Claim
Availity Atypical Provider Registration
Availity Checking Appeal Status
Availity Claim Status Tool Training
Availity Claims and Quick Claims
Availity Correcting a Claim
Availity Enhanced Claims Reporting
Availity Functionality Roadmap
Availity MCG Cite Guideline Transparency Access
Availity Medicaid Redetermination QRG
Availity Multiple PA Requests
Availity Secure Messaging
Availity Smart Claims Training
Availity Submit a Quick Claim for Atypical Providers
Availity Submit and Track Appeals
Availity Sunsetting Legacy Portal
Availity Sunsetting Legacy Portal Reminder
Critical Incident Reference Guide
EOP and 835 Reference Guide
FQHC Encounter Clinic Billing Quick Reference Guide
Guide to HFS MEDI Eligibility Search
Guide to Provider Changes
IDPH COVID-19 Paxlovid Checklist Tool for Prescribers
Marketplace Providers FAQ
Marketplace Providers Quick Reference Guide
MCG 27th Edition Summary of Changes
New Century Health Data Sheet, Cardiology
New Century Health Data Sheet, Oncology
New Century Health FAQ Quick Reference Guide
Open Enrollment Guide
Patient Health Resources
Quick Reference Contact Sheet
Roster Template Frequently Asked Questions
Roster Training Presentation
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