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Provider Manual

ACE Edits

Ambulance Fee Schedule Methodology

ASC Facility Claims Billing TIPS

Bariatric Services

Behavioral Analysis


Claim Payments

Claims Submission

Combined Payments

Coordination of Benefits


Dental Predeterminations

Dental restorations involving implants

Diabetes Prevention Program 

Drug Administration Policy

Durable Medical Equipment Rental

Electronic Data Interchange 835 Crosswalk

Electronic Remittance Advice

Eligible Providers

Facility Dispute Resolution Procedure

Fee Schedule Requests

Fee Schedule Updates

Guidelines for Osteopathic Manipulation, Physical/Occupational Therapy and Chiropractic Therapy

HealthChoice Contact Information

HealthChoice Pharmacy Benefits

HealthChoice Select

Home Health Care Services

Infusion Therapy

Inpatient Facility Reimbursement

Inpatient Post-Payment Review

Intraoperative Neurophysiologic Monitoring


IRS Form 1099

Laboratory Drug Screenings

Medical Records Request

Medicare Part D

Member Handbooks

Member Responsibilities


NDC pricing on fee schedules

Network Management Unit

Network News Email Address

Network News Newsletter

Network Provider Termination

Nominate a Provider

Orthodontic Benefits

Outpatient CMS J1 Status Indicator Fee Modeling

Outpatient Facility Reimbursement


Pharmacy Step Therapy Exception

Plan Exclusions and Limitations

Preventive Services and Modifier 33

Prior Authorization for Medication Process

Provider Claim Inquiries

Provider Self-Service

Referring to Network Providers

Speech Therapy


Telehealth Services

Timely Filing for Medical and Dental Claims

Transfer Reimbursement Methodology

Urgent Care Copay  

Utilization Review

Vaccines and their Administration under Pharmacy Benefits


Vision Benefits

Wig and Scalp Prostheses


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