{ "forms":[ { "title":"Practitioner Credentialing Rights", "date": "Mon Jul 15 17:38:26 UTC 2019", "link": "\/docs\/public\/inline\/practitioner-credentialing-rights-1218.pdf", "formsLibrary": ["pro_guides"] ,"topics": [""] } , { "title":"Consent to Release Form", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CT_00092.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Provider Dispute Resolution Request Form", "date": "Thu Feb 12 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_CA_00088.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Physicians Group Amendment", "date": "Thu Jun 30 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CA_00077.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Claims Re-process\/Inquiry Request", "date": "Wed May 19 12:00:00 UTC 2010", "link": "\/docs\/public\/inline\/P_CA_00094.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Credentialing Guideline Workbook", "date": "Fri Nov 06 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_CA_00103.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Non-Member Donor Transplant Form", "date": "Mon Jun 28 12:00:00 UTC 2010", "link": "\/docs\/public\/inline\/P_CA_00091.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Complex Case and Disease Management", "date": "Fri Nov 06 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_CA_00101.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Registering an Availity User for Anthem Services", "date": "Thu Apr 17 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/AVA1202-5-0414.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Cost Data Reports via Availity", "date": "Wed Oct 14 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_CA_00099.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Senate Bill 138 FAQs", "date": "Tue May 03 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CA_00070.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Senate Bill 137 (Provider Directory) FAQs", "date": "Fri Jul 08 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CA_00069.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Non-participating Provider Change Form – Instructions", "date": "Tue Jan 24 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_CA_00098.doc", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Prior Authorization Request", "date": "Thu Jul 31 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_CT_00179.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Electronic Member ID Cards Quick Reference Guide", "date": "Wed Sep 20 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_CT_00144.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Transition of Care Form", "date": "Mon Oct 07 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_CT_00173.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Transition of Care Form (Spanish)", "date": "Thu Sep 13 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_CT_00174.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Continuation of Care Form", "date": "Tue Aug 29 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_CT_00160.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Continuation of Care Form (Spanish)", "date": "Tue Aug 29 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_CT_00161.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Immunization Services FAQs", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CT_00118.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"OptiNet Registration FAQ", "date": "Tue Jul 16 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_GA_00116.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"OptiNet Assessment Tool for Sleep Management FAQs", "date": "Thu Jul 05 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_GA_00117.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Room Rate Request Form", "date": "Tue Apr 28 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_GA_00046.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Facilities"] } , { "title":"Quality Health First FAQs", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_IN_00455.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Enhanced Personal Health Care"] } , { "title":"OptiNet Assessment Tool for Sleep Management FAQs", "date": "Fri Apr 20 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_CE_00454.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Medical Record Submission Guidelines", "date": "Thu Mar 29 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_WI_00205.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Medical Record Submission Guidelines", "date": "Thu Aug 30 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_IN_00223.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Physician Extenders", "date": "Mon Jul 15 17:35:28 UTC 2019", "link": "\/docs\/public\/inline\/P_CE_00201.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative"] } , { "title":"Accessing Online Remits via Availity", "date": "Mon Jul 11 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CE_00213.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Medical Record Submission Guidelines", "date": "Fri Oct 03 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_OH_00218.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Physical Therapy\/Occupational Therapy UM Program FAQs", "date": "Thu Nov 03 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_OH_00129.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Fast Facts: Infusion Sites of Care", "date": "Tue Dec 08 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_WI_00201_b.pdf", "formsLibrary": ["pro_guides"] ,"topics":[] } , { "title":"Medicare Supplement System Consolidation FAQs", "date": "Mon Oct 03 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CE_00224.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicare Supplement System Consolidation FAQs", "date": "Tue May 24 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CT_00177.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Provider Claim Issue Escalation", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_KY_00203.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Provider Claim Issue Escalation", "date": "Fri Apr 13 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_OH_00228.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Imaging Program Expands", "date": "Mon Jul 15 18:04:43 UTC 2019", "link": "\/docs\/public\/inline\/P_CE_00200_jr.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Network eUpdate"] } , { "title":"Non-participating Provider Change Form – Instructions", "date": "Tue Jan 31 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_CE_00221.doc", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"High Risk Maternity Program Notification Form", "date": "Tue Jan 18 12:00:00 UTC 2005", "link": "\/docs\/public\/inline\/P_CT_00164.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Provider Dispute Resolution Request Form", "date": "Tue May 01 12:00:00 UTC 2007", "link": "\/docs\/public\/inline\/OH0012076.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Care Management Referral Form", "date": "Mon May 01 12:00:00 UTC 2006", "link": "\/docs\/public\/inline\/OH0012053.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Claims Resubmission Form", "date": "Fri Feb 01 12:00:00 UTC 2008", "link": "\/docs\/public\/inline\/OHW1225.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Claims Follow-Up Form", "date": "Fri Feb 01 12:00:00 UTC 2008", "link": "\/docs\/public\/inline\/OHW1226.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Identifying International Members", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_GA_00123.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["BlueCard"] } , { "title":"Consumer Directed Healthcare Plans (CDHP) and Healthcare Debit Cards", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_GA_00124.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Glossary of BlueCard Terms", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_GA_00121.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["BlueCard"] } , { "title":"Border County Provider Claims", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_GA_00127.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"SHBP Sample ID Cards – 2018", "date": "Mon Jan 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_GA_00109.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Affiliated Companies", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CE_00198.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Cover Letter for Medical Practitioners", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CE_00460.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Affiliated Companies", "date": "Thu Jul 28 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CA_00076.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Genetic Testing FAQs", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_GA_00131.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Non-participating Provider Change Form", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/P_CA_CE_00097.xlsm", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Electronic ID Cards Dental Quick Reference Guide", "date": "Sat Dec 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0002.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Dental","Patient Care"] } , { "title":"Dental Claim Form", "date": "Sat Dec 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals","Dental"] } , { "title":"Timely and Accurate Payment for Secondary Payer Medicare Claims", "date": "Mon Feb 10 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/Y0071_14_19149_I_001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Medicare & Medicaid"] } , { "title":"AIM Specialty Health Quick Reference Guide", "date": "Fri May 29 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_CA_00068.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools","Prior Authorizations"] } , { "title":"OptiNet Quick Reference Guide", "date": "Mon Jul 15 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_GA_00115.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools","Prior Authorizations"] } , { "title":"Health Delivery Organization\/Facility Application", "date": "Wed Apr 25 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_GA_00041.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Facilities","Contracting & Updates"] } , { "title":"CMS 1450 (UB-04) Claim Form", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/CMS1450_OH.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals","Medicare & Medicaid"] } , { "title":"CMS 1500 Claim Form", "date": "Mon Aug 01 12:00:00 UTC 2005", "link": "\/docs\/public\/inline\/CMS1500_OH.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals","Medicare & Medicaid"] } , { "title":"Timely and Accurate Payment for Secondary Payer Medicare Claims", "date": "Thu Feb 06 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_CE_00429.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Medicare & Medicaid"] } , { "title":"Health Delivery Organization\/Facility Application", "date": "Mon Jul 11 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CT_00163.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Facilities","Contracting & Updates"] } , { "title":"Health Delivery Organization\/Facility Application", "date": "Fri Jul 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CE_00220.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Facilities","Contracting & Updates"] } , { "title":"Quick Reference Guide to AIM Specialty Health", "date": "Fri Mar 10 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_OH_00126.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools","Prior Authorizations"] } , { "title":"Claims Flow through BlueCard", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_GA_00126.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","BlueCard"] } , { "title":"Cover Letter for Behavioral Health Practitioners", "date": "Thu Feb 02 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/27176MUSENMUB_GA.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care","Behavioral Health"] } , { "title":"BlueCard Claims Filing", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_GA_00125.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","BlueCard"] } , { "title":"Dental Review Guidelines", "date": "Sat Dec 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0005.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Dental"] } , { "title":"SHBP Medicare Advantage Sample ID Cards – 2018", "date": "Mon Jan 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_GA_00112.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care","Medicare & Medicaid"] } , { "title":"Preventive Care Services Covered with No Member Cost-share", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CE_00461.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act","Behavioral Health","Patient Care"] } , { "title":"Dental W9 Forms", "date": "Sat Dec 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0004.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Dental","Contracting & Updates"] } , { "title":"Standardized Maintenance Form", "date": "Sat Dec 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0034.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Dental","Contracting & Updates"] } , { "title":"CMS 1500 Paper Claim Filing Instructions", "date": "Sat Dec 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0006.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Dental","Claims & Appeals","Medicare & Medicaid"] } , { "title":"HLD Index Score Sheet", "date": "Sat Dec 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0007.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Dental","Prior Authorizations"] } , { "title":"Standardized Maintenance Form", "date": "Sat Dec 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0003.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Dental","Contracting & Updates"] } , { "title":"Standardized Maintenance Form", "date": "Sat Dec 01 00:00:00 UTC 2018", "link": "https:\/\/www11.empireblue.com\/shared\/noapplication\/f0\/s0\/t0\/pw_g257879.pdf?refer=ehpprovider", "formsLibrary": ["pro_forms"] ,"topics": ["Dental","Contracting & Updates"] } , { "title":"Commerical Measurement Period Handbook", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_GA_010119.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Enhanced Personal Health Care"] } , { "title":"Electronic Member ID Cards Quick Reference Guide", "date": "Mon Apr 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_MISC_0003.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care","Affordable Care Act"] } , { "title":"Inovalon – Incentive Opportunity for Physicians", "date": "Mon Apr 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_MISC_0004.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Institutional Provider Change Request", "date": "Mon Apr 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_MISC_0005.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Applied Behavior Analysis (ABA) County Service Form", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Patient Consent to Exchange Information", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Eating Disorder Facility Profile", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00003.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Facility Change Request", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00004.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Behavioral Health Practice Profile", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00005.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Behavioral Health Practice Update – Individual", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00006.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Behavioral Health Practice Update – Group", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00007.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Network Participation Request – Behavioral Health Facility", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00009.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Facilities","Behavioral Health"] } , { "title":"Behavioral Health Guide – Groups", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_0060119.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Behavioral Health Guide – Individuals", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00011.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Behavioral Health Guide – Facilities", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_060119.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Treatment Plan Request for Autism Spectrum Disorders", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Treatment Plan Request for Autism Spectrum Disorders", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NY_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Assessment Request for Autism Spectrum Disorders", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NY_BH_00002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Behavioral Health Outpatient Treatment Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CO_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Behavioral Health Outpatient Treatment Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CT_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Behavioral Health Outpatient Treatment Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/GA_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Behavioral Health Outpatient Treatment Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CE_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Behavioral Health Outpatient Treatment Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/ME_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Behavioral Health Outpatient Treatment Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NH_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Behavioral Health Outpatient Treatment Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NY_BH_00003.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Condition Care\/Case Management Referral", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_BH_00004.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Outpatient Therapy Treatment Report – FEP", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_BH_00005.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Psychotherapy Notes Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/ABCBS_BH_00002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Psychotherapy Notes Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NY_BH_00005.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Individual Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00020.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Individual Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/W_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Individual Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NE_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Individual Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CE_BH_00002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Individual Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NH_BH_00002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Individual Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NY_BH_00006.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Individual Release Authorization", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/VA_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Transcranial Magnetic Stimulation (TMS) Request", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_BH_00021.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Transcranial Magnetic Stimulation (TMS) Request", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NE_BH_00002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Transcranial Magnetic Stimulation (TMS) Request", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CE_BH_00003.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Transcranial Magnetic Stimulation (TMS) Request", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/NY_BH_00007.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Alcohol Use Assessment Brochure", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_BH_00007.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Edinburgh Postnatal Depression Scale (EPDS)", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_BH_00008.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Opiod Use Assessment Brochure", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_BH_00009.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Substance Brief Intervention\/Referral Tool (SBIRT)", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_BH_00010.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Vanderbilt ADHD Diagnostic Parent Rating Scale", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_BH_00011.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Coordination of Care Letter Template – Medical", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/27175MUSENMUB-.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health","Patient Care"] } , { "title":"Coordination of Care Letter Template – Behavioral Health", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/27176MUSENMUB-.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health","Patient Care"] } , { "title":"Coordination of Care Form", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/27160MUSENMUB-.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health","Patient Care"] } , { "title":"Affordable Care Act Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CO_00334.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NV_00242.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Preventive Care Services Covered with No Member Cost-share ", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CO_00335.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Preventive Care Services Covered with No Member Cost-share ", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NV_00243.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Preventive Care Services Covered with No Member Cost-share", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00131.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Health Insurance Exchange Quick Reference Guide ", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_IN_00462.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Health Insurance Exchange Quick Reference Guide ", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_KY_00428.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Health Insurance Exchange Quick Reference Guide - 2020", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_OH_00458.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Health Insurance Exchange Quick Reference Guide ", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_WI_00451.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CT_00181.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_ME_00176.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00179.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CT_00182.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_ME_00177.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00180.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Preventive Care Services Covered with No Member Cost-share", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00097.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CA_00115.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Preventive Care Services Covered with No Member Cost-share", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CA_00116.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_GA_00320.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Preventive Care Services Covered with No Member Cost-share", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_GA_00321.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Commercial Medical Record Review Process and Standards", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_MR_CA_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medical Records"] } , { "title":"Problem List & Health Maintenance – Adult", "date": "Mon Feb 04 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_MR_00008.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medical Records"] } , { "title":"Pregnancy: Your Birth Options After Cesarean", "date": "Mon Feb 18 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_S_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Commercial Medical Record Standards", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_MR_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medical Records"] } , { "title":"History Record – Pediatric", "date": "Mon Feb 04 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_MR_00002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medical Records"] } , { "title":"Medication List – Pediatric", "date": "Mon Feb 04 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_MR_00003.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medical Records"] } , { "title":"Problem List & Health Maintenance – Pediatric", "date": "Mon Feb 04 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_MR_00004.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medical Records"] } , { "title":"Progress Notes – Pediatric", "date": "Mon Feb 04 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_MR_00005.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medical Records"] } , { "title":"Physical Examination – Adult", "date": "Mon Feb 04 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_MR_00006.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medical Records"] } , { "title":"Medication List – Adult", "date": "Mon Feb 04 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_MR_00007.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medical Records"] } , { "title":"AIM Specialty Health (AIM) Quick Reference Guide", "date": "Wed Apr 29 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_AIM_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"AIM Specialty Health (AIM) Overview", "date": "Wed Jun 08 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_AIM_00002.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Specialty Pharmacy Program Expansion – Level of Care Review FAQs", "date": "Mon Feb 27 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_W_00183.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Interactive Voice Response System (IVR) Quick Reference Guide – FEP", "date": "Fri Jan 02 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_CO_00197.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Escalation Contact List", "date": "Mon Apr 29 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CO_claim_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Contracting & Updates","Prior Authorizations"] } , { "title":"Prefix Reference List", "date": "Tue Jan 29 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CO_claim_00002.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"Additional Information Requested Form", "date": "Fri Sep 19 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_CO_00219.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Blue Priority Referral", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CO_00220.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Claim Action Request", "date": "Wed Feb 16 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_CO_00221.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Coordination of Benefits (COB) Questionnaire", "date": "Fri Aug 07 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_W_00222.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Designation of an Authorized Representative (DOR)", "date": "Fri Aug 13 12:00:00 UTC 2004", "link": "\/docs\/public\/inline\/P_W_00223.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Fax Authorization", "date": "Tue Sep 05 12:00:00 UTC 2006", "link": "\/docs\/public\/inline\/P_CO_00224.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Health Delivery Organization\/Facility Application", "date": "Fri Jul 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CO_00225.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates","Facilities"] } , { "title":"Individual Authorization", "date": "Fri Sep 28 12:00:00 UTC 2007", "link": "\/docs\/public\/inline\/P_CO_00226.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Member Liability Waiver", "date": "Wed Feb 13 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_W_00228.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Electronic Member ID Cards Quick Reference Guide", "date": "Mon Sep 18 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_CO_00231.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Diabetes Prevention Program Overview", "date": "Thu Jan 28 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CO_00300.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Diabetes Prevention Program Patient Recommendation Form", "date": "Wed Jan 27 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CO_00301.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Diabetes Prevention Program Quick Reference Guide", "date": "Wed Jan 27 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_CO_00302.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"CAQH Solution: COB Smart FAQs", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_CO_00310.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"OptiNet Assessment Tool for Sleep Management FAQs", "date": "Thu Sep 20 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_CO_00321.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Certified Nurse Midwife Collaborative Template", "date": "Fri Apr 15 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NY_00039.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Coordination of Benefits (COB) Questionnaire", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00040.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"EDI Registration Form", "date": "Tue Dec 06 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NY_00041.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Waiver for Non Covered Service", "date": "Thu May 05 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NY_00042.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"National Provider Identification (NPI) Registration", "date": "Thu May 05 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NY_00043.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"General Fax Authorization Request", "date": "Fri Jan 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NY_00045.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Health Delivery Organization\/Facility Application", "date": "Fri Jul 22 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NY_00046.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Facilities","Contracting & Updates"] } , { "title":"Individual Provider Billing Address Update", "date": "Fri Oct 20 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NY_00047.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Individual Provider Record Update", "date": "Fri Oct 20 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NY_00048.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Individual Provider Tax ID Update", "date": "Fri Oct 20 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NY_00049.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Managed Care Referral", "date": "Wed May 31 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NY_00050.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Medical Record Submission", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00051.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Medicare Advantage General Precertification Request", "date": "Fri Dec 18 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_NY_00052.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Medicare & Medicaid"] } , { "title":"Notice of Denial of Medical Coverage", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00053.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Obsterical Fax Authorization", "date": "Tue Mar 07 12:00:00 UTC 2006", "link": "\/docs\/public\/inline\/P_NY_00054.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Primary Care Physician (PCP) Patient Coverage Waiver", "date": "Wed Nov 07 12:00:00 UTC 2007", "link": "\/docs\/public\/inline\/P_NY_00055.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Refund Check Information Form", "date": "Mon Mar 02 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_NY_00056.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Specialist Patient Coverage Waiver", "date": "Fri Jan 11 12:00:00 UTC 2008", "link": "\/docs\/public\/inline\/P_NY_00057.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Walk-In Doctor's Office Provider Request Form", "date": "Tue Feb 21 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_NY_00058.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Claim Attachment Cover Sheet", "date": "Fri Jan 28 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NY_00059.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Electronic Claims Submissions Guide", "date": "Fri Jan 28 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NY_00060.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Behavioral Health Initial Review", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00062.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Behavioral Health Concurrent Review", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00064.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Neuropsychological Testing Authorization Request", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00066.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health","Prior Authorizations"] } , { "title":"Electroconvulsive Therapy Authorization Request", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00068.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health","Prior Authorizations"] } , { "title":"Behavioral Health Discharge Note", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00076.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Psychological Testing Authorization Request", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00077.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Consent to Release Template", "date": "Wed Jan 26 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NY_00079.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Behavioral Health Provider Profile", "date": "Wed Feb 15 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_NY_00083.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health","Contracting & Updates"] } , { "title":"FAQs for Behavioral Health Institutional Providers", "date": "Thu Sep 24 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_NY_00086.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"FAQs for Behavioral Health Professional Providers", "date": "Thu Sep 24 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_NY_00087.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Empire Fastcheck IVR Guide for Medical Providers", "date": "Tue Jan 22 12:00:00 UTC 2008", "link": "\/docs\/public\/inline\/P_NY_00090.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"Empire Fastcheck IVR Guide for Hospital Providers", "date": "Tue Jan 22 12:00:00 UTC 2008", "link": "\/docs\/public\/inline\/P_NY_00091.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"Quick Reference Guide for Institutional Behavioral Health Providers", "date": "Thu Sep 24 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_NY_00092.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Quick Reference Guide for Professional Behavioral Health Providers", "date": "Thu Sep 24 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_NY_00093.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Behavioral Health"] } , { "title":"Claim Submission Guide – NYC Accounts", "date": "Tue Jun 06 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NY_00094.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Services Requiring Pre-Certification for City of New York Employees", "date": "Wed Nov 09 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NY_00095.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Fax Authorization Request – NYC Healthline", "date": "Tue May 17 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NY_00096.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Claim Submission Guide – NY State Health Insurance Program", "date": "Tue Jun 06 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NY_00097.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Physician Office Lab (POL) List", "date": "Wed May 16 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_NY_00098.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Site of Service (SOS) Reductions", "date": "Fri Feb 23 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_NY_00099.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Affordable Care Act Quick Reference Guide", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00112.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Member ID Card Summary for ACA-compliant Health Plans", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00113.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Integrated Care Model for Plans on the Health Insurance Marketplace", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00115.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Access More Information about Three-month Grace Period Status", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00119.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Medicare Advantage HMO & PPO Provider Guidebook", "date": "Wed Dec 27 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NY_00121.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"MediBlue Member ID Card Samples", "date": "Fri Dec 23 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NY_00122.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"CAQH Solution: COB Smart FAQs", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00124.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Medicare Supplement System Consolidation FAQs ", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00125.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Specialty Pharmacy Program Expansion - Level of Care Review FAQs ", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00126.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Certification and Attestation for Physician Primary Care Rate Increase", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00160.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Electronic Member ID Cards Quick Reference Guide", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00077.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Preventive Care Code List", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00079.xls", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Accessing Online Remits via Availity", "date": "Wed Jun 03 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_VA_00089.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Affiliated Companies", "date": "Wed Dec 28 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_VA_00094.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"BlueCard Claims Filing", "date": "Thu Jul 23 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_VA_00095.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Provider Appeal Policy and Procedure", "date": "Wed Apr 27 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_VA_00096.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Claim Reconsideration and Appeals", "date": "Tue Jun 17 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_VA_00098.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Timely and Accurate Payment for Secondary Payer Medicare Claims", "date": "Wed May 18 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_VA_00099.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Medicare & Medicaid"] } , { "title":"Medicare Supplement System Consolidation FAQs", "date": "Fri May 20 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_VA_00100.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Health Care Delivery Organization\/Facility Application", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00104.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Facilities","Contracting & Updates"] } , { "title":"Provider Maintenance Form Guide", "date": "Wed Apr 04 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_VA_00105.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Claim Information\/Adjustment Request 151 Form", "date": "Thu Jan 23 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_VA_00107.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Claim Information Adjustment Request 151 Form For Medicaid Claims", "date": "Wed Sep 09 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_VA_00108.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals","Medicare & Medicaid"] } , { "title":"Provider Overpayment Refund Form", "date": "Wed Mar 30 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_VA_00109.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Coordination of Benefits (COB) Questionnaire – FEP", "date": "Tue Jul 07 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_VA_00110.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"COB Questionnaire – Participating PPO and HMO", "date": "Mon Jul 27 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_VA_00111.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Sample Waiver Consent Form", "date": "Wed Apr 13 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_VA_00112.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Pregnancy Notification Report", "date": "Tue Jan 14 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_VA_00114.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Medicare Advantage General Precertification Request", "date": "Thu May 12 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_VA_00115.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-coverage", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00116.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Physician Office Lab (POL) List", "date": "Thu Feb 01 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_VA_00119.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Site of Service (SOS) Reductions", "date": "Tue Mar 13 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_VA_00120.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Surgery for Clinically Severe Obesity Procedure Review", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00125.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Inpatient Orthognathic Surgery Procedure Review", "date": "Wed Apr 04 12:00:00 UTC 2007", "link": "\/docs\/public\/inline\/P_VA_00126.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Inpatient Initial Review", "date": "Fri Aug 20 12:00:00 UTC 2010", "link": "\/docs\/public\/inline\/P_VA_00127.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Continued Stay Review", "date": "Thu Mar 22 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_VA_00128.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Lumbar Spine Procedure Review", "date": "Wed Nov 26 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_VA_00129.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Helpful Tips For Using Anthem's Point Of Care Authorization System", "date": "Thu Apr 08 12:00:00 UTC 2010", "link": "\/docs\/public\/inline\/P_VA_00130.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Outpatient Orthognathic Surgery Procedure Review", "date": "Mon Feb 27 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_VA_00131.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Helpful Tips For Using Anthem's Point Of Care Authorization System", "date": "Fri Aug 20 12:00:00 UTC 2010", "link": "\/docs\/public\/inline\/P_VA_00133.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Diagnostic Sleep Study Review Request – Adult", "date": "Wed Mar 13 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_VA_00137.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Diagnostic Sleep Study Review Request – Pediatric", "date": "Wed Mar 13 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_VA_00138.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Titration Study Review Request", "date": "Wed Mar 13 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_VA_00139.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Initial Treatment with APAP\/ BPAP\/ CPAP & Supplies Review Request", "date": "Wed Mar 13 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_VA_00140.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Ongoing Treatment with APAP\/ BPAP\/ CPAP & Supplies Review Request", "date": "Wed Mar 13 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_VA_00141.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Treatment with Oral Appliance Review Request", "date": "Wed Mar 13 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_VA_00142.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Atlantic Health Partners Vaccine Purchasing Program", "date": "Fri Oct 09 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_VA_00143.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Common ID Card Prefixes for Business", "date": "Thu Feb 08 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_VA_00144.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"Licensed Clinical Social Worker Certification Form - Intensive Level Services", "date": "Mon Jun 03 19:25:10 UTC 2019", "link": "\/docs\/public\/inline\/WI_CERT_00001.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Licensed Clinical Social Worker Certification Form - Non-Intensive Level ", "date": "Mon Jun 03 19:18:30 UTC 2019", "link": "\/docs\/public\/inline\/WI_CERT_00002.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Outpatient Mental Health Clinic Certification Form", "date": "Mon Jun 03 19:25:13 UTC 2019", "link": "\/docs\/public\/inline\/WI_CERT_00003.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Autism Paraprofessional Certification Form", "date": "Mon Jun 03 19:18:28 UTC 2019", "link": "\/docs\/public\/inline\/WI_CERT_00004.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Occupational Therapist and Speech Therapist Certification Form ", "date": "Mon Jun 03 19:16:57 UTC 2019", "link": "\/docs\/public\/inline\/WI_CERT_00005.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Health Insurance Exchange Quick Reference Guide ", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_MO_00427.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Tips for Billing CPT Modifier 33", "date": "Wed Oct 19 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NE_00056.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Sample Member Letter", "date": "Mon Jun 01 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_ME_00067.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Asthma Patient Flyer", "date": "Wed Jun 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NE_00068.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"CAD Patient Flyer", "date": "Wed Jun 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NE_00069.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"COPD Patient Flyer", "date": "Wed Jun 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NE_00070.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Diabetes Patient Flyer", "date": "Wed Jun 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NE_00071.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Heart Failure Patient Flyer", "date": "Wed Jun 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NE_00072.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Facility Maintenenace Form - Maine", "date": "Mon May 11 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_ME_00074.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Coordination of Benefits (COB) Questionnaire", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NE_00075.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Health Delivery Organization\/Facility Application", "date": "Mon Jul 11 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NE_00076.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates","Facilities"] } , { "title":"Medicare Advantage General Precertification Request", "date": "Thu May 05 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_S_00077.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations","Medicare & Medicaid"] } , { "title":"Medical Record Submission Form", "date": "Tue Jun 06 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NE_00078.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Modifier 22 (Unusual Procedural Services) Explanation", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NE_00079.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals","Medicare & Medicaid"] } , { "title":"Non-Par Provider Change Request", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/P_ME_00080.xlsm", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Outpatient Treatment Report -- FEP", "date": "Wed Oct 28 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_NE_00082.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Overpayment Adjustment Request", "date": "Wed Aug 13 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_NE_00083.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"BiPAP Prior Authorizations Request", "date": "Thu Sep 23 12:00:00 UTC 2004", "link": "\/docs\/public\/inline\/P_ME_00085.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Inpatient\/Outpatient Prior Authorization Request", "date": "Thu Jul 31 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_NE_00087.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"How to Appeal Our Determination – First Level", "date": "Tue Jul 17 12:00:00 UTC 2007", "link": "\/docs\/public\/inline\/P_ME_00088.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"How to Appeal Our Determination – Second Level", "date": "Tue Jul 17 12:00:00 UTC 2007", "link": "\/docs\/public\/inline\/P_ME_00089.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Independent External Review of a Denied Claim", "date": "Tue Jul 17 12:00:00 UTC 2007", "link": "\/docs\/public\/inline\/P_ME_00090.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Discharge Planning Guideline", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NE_00091.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care","Facilities"] } , { "title":"Coordination of Care Information", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_ME_00092.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Complaints and Appeals Information", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_ME_00093.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Prior Authorization Process for Intensive Services", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_ME_00094.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations","Behavioral Health"] } , { "title":"Coordination of Care Letter Template", "date": "Fri Jan 21 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NE_00106.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Child Attention Profile (CAP)", "date": "Mon Feb 17 12:00:00 UTC 2003", "link": "\/docs\/public\/inline\/P_ME_00115.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Child Attention Profile (CAP) (Spanish)", "date": "Thu Mar 11 12:00:00 UTC 2004", "link": "\/docs\/public\/inline\/P_ME_00116.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Clinical Information Required for Claim Adjudication", "date": "Fri Dec 02 12:00:00 UTC 2005", "link": "\/docs\/public\/inline\/P_ME_00138.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"HCPCS and CPT Code Requirements for Outpatient Claims", "date": "Wed May 02 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_NE_00139.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Overpayment Recovery Process", "date": "Thu Jan 26 12:00:00 UTC 2006", "link": "\/docs\/public\/inline\/P_ME_00142.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Interactive Voice Response System (IVR) Quick Reference Guide", "date": "Mon Aug 09 12:00:00 UTC 2010", "link": "\/docs\/public\/inline\/P_ME_00167.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Precertification\/Prior Authorization Guidelines", "date": "Thu Dec 14 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_ME_00168.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Accessing Online Remits via Availity", "date": "Fri Oct 10 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_ME_00171.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Introduction to the ASAM Criteria for Members", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00082.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Provider Claim Issue Escalation", "date": "Fri Feb 23 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_NH_00097.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Interactive Voice Response System (IVR) Quick Reference Guide", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00098.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Interactive Voice Response System Quick Reference Guide (NEHP-specific)", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00099.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Payment Inquiry Form", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00102.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Remittance Advice Overview – BlueCard", "date": "Tue Nov 21 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NH_00103.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Remittance Advice Overview – FEP", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00104.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Remittance Advice Overview – Professional", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00105.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Waiver for Non Covered Service", "date": "Wed Nov 09 12:00:00 UTC 2005", "link": "\/docs\/public\/inline\/P_NH_00106.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Waiver for Non Covered Service – Instructions", "date": "Mon Jul 22 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_NH_00107.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"OrthoNet Fact sheet", "date": "Fri May 25 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_NH_00147.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"OrthoNet Physical and Occupational Therapy Program FAQs", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00148.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Precertification Requirements for New Hampshire Health Plans", "date": "Thu Dec 14 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NH_00149.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Electronic Member ID Cards Quick Reference Guide", "date": "Wed Sep 20 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NH_00157.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Continuation of Care Form", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00160.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"High Risk Maternity Program Notification Form", "date": "Tue Jan 18 12:00:00 UTC 2005", "link": "\/docs\/public\/inline\/P_NH_00163.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"New Hampshire Referral Form", "date": "Wed Nov 09 12:00:00 UTC 2005", "link": "\/docs\/public\/inline\/P_NH_00169.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Facility Maintenance Form", "date": "Thu May 14 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_NH_00174.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Facilities","Contracting & Updates"] } , { "title":"Transition of Care Form", "date": "Fri Jan 16 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_NH_00175.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"AIM Specialty Health (AIM) Quick Reference Guide", "date": "Wed Apr 29 12:00:00 UTC 2015", "link": "\/docs\/public\/inline\/P_NV_00183.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"AIM Specialty Health (AIM) Overview", "date": "Mon Jun 06 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NV_00184.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Request for Transition Authorization", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NV_00192.xls", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Interactive Voice Response System (IVR) Quick Reference Guide – FEP", "date": "Fri Jan 02 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_NV_00193.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Additional Information Requested Form", "date": "Fri Sep 19 12:00:00 UTC 2014", "link": "\/docs\/public\/inline\/P_NV_00194.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Claim Action Request", "date": "Wed Feb 16 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NV_00195.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Fax Authorization", "date": "Tue Sep 05 12:00:00 UTC 2006", "link": "\/docs\/public\/inline\/P_NV_00198.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Prior Authorizations"] } , { "title":"Health Delivery Organization\/Facility Application", "date": "Fri Jul 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NV_00199.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Facilities","Contracting & Updates"] } , { "title":"Provider Dispute Resolution Form", "date": "Wed Feb 16 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/P_NV_00204.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Provider Refund Adjustment Request", "date": "Wed Jun 30 12:00:00 UTC 2010", "link": "\/docs\/public\/inline\/P_NV_00205.xls", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Urgent Care or Walk-In Doctor’s Office Information Update", "date": "Mon Mar 11 12:00:00 UTC 2013", "link": "\/docs\/public\/inline\/P_NV_00206.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Contracting & Updates"] } , { "title":"Electronic Member ID Cards Quick Reference Guide", "date": "Mon Sep 18 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NV_00207.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Immediate Authorization Decisions via ICR", "date": "Tue Mar 28 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NV_00212.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Introducing Interactive Care Reviewer (ICR)", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NV_00213.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Thu Oct 26 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NV_00215.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"ASC Grouper Listing", "date": "Tue Jan 16 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_NV_00217.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Commercial Risk Adjustment Program Overview", "date": "Mon Oct 30 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NV_00218.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Escalation Contact List", "date": "Mon Feb 04 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NV_00219.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Contracting & Updates","Prior Authorizations"] } , { "title":"Networks at a Glance", "date": "Thu Oct 26 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NV_00220.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"Networks Overview", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NV_00221.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"OrthoNet Quick Reference Guide", "date": "Thu Dec 01 12:00:00 UTC 2016", "link": "\/docs\/public\/inline\/P_NV_00222.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Prefix Reference List", "date": "Tue Oct 09 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_NV_00223.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"CAQH Solution: COB Smart FAQs", "date": "Wed Feb 20 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NV_00229.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"National Provider Identifier (NPI) FAQs", "date": "Tue Oct 06 12:00:00 UTC 2009", "link": "\/docs\/public\/inline\/P_W_00238.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"OptiNet Assessment Tool for Sleep Management FAQs", "date": "Thu Sep 20 12:00:00 UTC 2012", "link": "\/docs\/public\/inline\/P_NV_00240.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Provider Adjustment Form Instructions Sheet", "date": "Fri Jul 01 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/PA_CE_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Provider Adjustment"] } , { "title":"Provider Adjustment Form - DOC File ", "date": "Fri Jul 01 12:00:00 UTC 2011", "link": "\/docs\/public\/inline\/PA_CE_00002.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Health Insurance Exchange Quick Reference Guide", "date": "Mon Oct 30 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_NV_00216.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Affordable Care Act Compliant Health Plans Quick Reference Guide", "date": "Tue Jan 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NH_00068.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Electronic Member ID Cards Quick Reference Guide", "date": "Wed Sep 20 12:00:00 UTC 2017", "link": "\/docs\/public\/inline\/P_ME_00073.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Preventive Care Services Covered with No Member Cost-share", "date": "Tue Jan 01 00:00:00 UTC 2019", "link": "\/docs\/public\/inline\/P_NE_00100.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"ASC Grouper Listing", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g294955.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Commercial Risk Adjustment Program Overview", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g277933.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Colorado Networks at a Glance", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e235753.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"Colorado Networks Overview", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g298733.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations"] } , { "title":"Plans Offered in Colorado – 2019", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g277934.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations","Affordable Care Act"] } , { "title":"Plans Offered in Nevada – 2019", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g282930.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals","Prior Authorizations","Affordable Care Act"] } , { "title":"Claims Refunds and Recoups Presentation", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g356767.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Medical Record Requests Presentation", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g359820.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Claim Submission and Adjustment Request Tips and Tools Presentation", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g356768.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Member Identification Eligibility and Benefits Presentation", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g354790.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Coding Compensation Collaboration Policy", "date": "Mon Jul 15 17:33:14 UTC 2019", "link": "\/docs\/public\/inline\/P_CA_00200.pdf", "formsLibrary": ["pro_guides"] ,"topics": [""] } , { "title":"Site of Service (SOS) Reductions", "date": "Mon Jul 15 17:34:22 UTC 2019", "link": "\/docs\/public\/inline\/P_NY_00201.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care","Claims"] } , { "title":"PCP Physician Office Lab (POL) List", "date": "Mon Jul 15 17:34:36 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00200.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"SCP Physician Office Lab (POL) List", "date": "Mon Jul 15 17:34:51 UTC 2019", "link": "\/docs\/public\/inline\/P_VA_00201.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Not Otherwise Classified (NOC) Drug", "date": "Mon Jul 15 16:09:28 UTC 2019", "link": "", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative"] } , { "title":"Locum Tenens", "date": "Mon Jul 15 17:29:45 UTC 2019", "link": "\/docs\/public\/inline\/CRHPA005.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Anthem Blue Cross and Blue Shield Provider Appeal Checklist", "date": "Tue Oct 01 22:21:56 UTC 2019", "link": "\/docs\/public\/inline\/P_ABCBS_00200.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Claims & Appeals"] } , { "title":"Medical Management Interactive Voice Response (IVR)", "date": "Mon Jul 15 16:54:10 UTC 2019", "link": "\/docs\/public\/inline\/CT_CONTACT_00004.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Dental Web Portal Notification", "date": "Thu Aug 15 14:50:26 UTC 2019", "link": "\/docs\/public\/inline\/ANT.91.18_ANTHEMBC.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Dental"] } , { "title":"Dental Web Portal Notification", "date": "Thu Aug 15 14:49:46 UTC 2019", "link": "\/docs\/public\/inline\/ANT.91.18_ANTHEMBCBS.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Dental"] } , { "title":"Dental Web Portal Notification", "date": "Thu Aug 15 14:51:22 UTC 2019", "link": "\/docs\/public\/inline\/ANT.91.18_EMPBCBS.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Dental"] } , { "title":"Download the Manual", "date": "Mon Jul 15 17:12:17 UTC 2019", "link": "\/docs\/public\/inline\/DENT_ABC_00100.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Dental"] } , { "title":"Clinical Data Sharing", "date": "Mon Jul 15 17:08:13 UTC 2019", "link": "\/docs\/public\/inline\/P_CE_00205_jr.pdf", "formsLibrary": ["pro_guides"] ,"topics":[] } , { "title":"Download the Dental Provider Reference Manual", "date": "Mon Jul 15 17:08:51 UTC 2019", "link": "\/docs\/public\/inline\/DENT_ABCBS_00100.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Dental"] } , { "title":"Learn how to request an appeal", "date": "Mon Jul 15 17:45:53 UTC 2019", "link": "\/docs\/public\/inline\/66998MUSENMUB.pdf", "formsLibrary": ["pro_guides"] ,"topics":[] } , { "title":"Learn how to request an appeal", "date": "Mon Jul 15 16:24:08 UTC 2019", "link": "", "formsLibrary": ["pro_guides"] ,"topics": [""] } , { "title":"Learn how to request an appeal", "date": "Mon Jul 15 17:37:56 UTC 2019", "link": "\/docs\/public\/inline\/CLAIMS_CE_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": [""] } , { "title":"Learn how to request an appeal", "date": "Mon Jul 15 17:38:06 UTC 2019", "link": "\/docs\/public\/inline\/CLAIMS_NV_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": [""] } , { "title":"Learn how to request an appeal", "date": "Mon Jul 15 17:38:14 UTC 2019", "link": "\/docs\/public\/inline\/CLAIMS_VA_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": [""] } , { "title":"Medicare Advantage Precertification Requirements – 2018", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_b141093.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicare Advantage Precertification Requirements – 2019", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e238188.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicare Advantage Precertification Requirements – 2017", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g257182.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicare Advantage Precertification Request", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e168071.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Detailed Explanation of Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179169.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179170.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179171.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179217.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Detailed Explanation of Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179172.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179173.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179174.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179218.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179176.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179177.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179178.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e228837.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179182.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Detailed Explanation of Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e205264.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e205265.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e205272.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e205273.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179179.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179180.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179181.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e228838.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179188.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Detailed Explanation of Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e205274.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e205275.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e205276.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e205277.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e228839.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179189.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179185.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179186.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179187.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e228840.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179183.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"What Beneficiary Notice Form to Use", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e178193.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Detailed Explanation of Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e178196.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e178195.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e178197.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e178194.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Detailed Explanation of Non-Coverage (EBC)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179666.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage (EBC)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179668.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment (EBC)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179670.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage (EBC)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": 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"link": "\/docs\/public\/inline\/pw_a031291.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicard Advantage Member ID Card Sample", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g290330.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicard Advantage Member ID Card Sample", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g290331.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicard Advantage Member ID Card Sample", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g290334.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicard Advantage Member ID Card Sample", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g290336.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicard 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2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_005.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training"] } , { "title":"Treatment Plan Request for Autism Spectrum Disorders", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/CA_TPRF_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Treatment Plan Request for Autism Spectrum Disorders", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/IN_BH_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Treatment Plan Request for Autism Spectrum Disorders", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/VA_TPR_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Treatment Plan Request for Autism Spectrum Disorders - FEP", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_FEP_00001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Healthlink Treatment Plan Request for Autism Spectrum Disorders", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/MO_Healthlink_Codes.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"National System Provider (Voucher) Remittance Advice Explanation", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_006.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training"] } , { "title":"National System Provider (Voucher) Remittance Advice Explanation", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_007.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training"] } , { "title":"Provider Commercial Refund Request Letter Sample", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_008.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training"] } , { "title":"Provider Remittance Advice 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Agreement Affiliates List", "date": "Fri Sep 06 18:09:01 UTC 2019", "link": "\/docs\/public\/inline\/CO_Affiliates_0001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Specialty Pharmacy Program Expansion - Level of Care Review FAQs", "date": "Wed Sep 18 14:03:21 UTC 2019", "link": "\/docs\/public\/inline\/SPEC_PHARM_CT.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Pharmacy"] } , { "title":"Telehealth Services Guideline", "date": "Fri Sep 06 18:14:11 UTC 2019", "link": "\/docs\/public\/inline\/CT_Telehealth_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"IVF Policy", "date": "Thu Oct 03 13:20:47 UTC 2019", "link": "\/docs\/public\/inline\/CT_IVF_Policy_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"ASC Grouper Listing", "date": "Fri Sep 06 19:02:25 UTC 2019", "link": "\/docs\/public\/inline\/ASC_Grouper_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Commercial Risk Adjustment: Program Overview", "date": "Fri Sep 06 19:04:02 UTC 2019", "link": "\/docs\/public\/inline\/RISK_ADJUST_OVERVIEW_CO.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Networks at a Glance", "date": "Fri Sep 06 19:06:18 UTC 2019", "link": "\/docs\/public\/inline\/Networks_CO_001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Networks Overview", "date": "Fri Sep 06 21:42:27 UTC 2019", "link": "\/docs\/public\/inline\/Networks_CO_002.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Updates Regarding Physician Assistants as Primary Medical Providers", "date": "Fri Sep 06 22:14:43 UTC 2019", "link": "\/docs\/public\/inline\/HIP_HOOSIER_IN_001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Hoosier Care Connect and Healthy Indiana Plan: Health Plan Amendment  ", "date": "Fri Sep 06 22:16:04 UTC 2019", "link": "\/docs\/public\/inline\/HIP_HOOSIER_IN_002.pdf", "formsLibrary": ["pro_guides"] ,"topics":[] } , { "title":"Mailing Addresses for Paper Claims and Claims Related Correspondence", "date": "Fri Sep 06 22:35:52 UTC 2019", "link": "\/docs\/public\/inline\/IN_CLAIMS_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Provider Claim Issue Escalation to Network Relations", "date": "Fri Sep 06 22:37:19 UTC 2019", "link": "\/docs\/public\/inline\/IN_CLAIMS_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Health Insurance Exchange Quick Reference Guide - 2019", "date": "Fri Sep 06 22:41:40 UTC 2019", "link": "\/docs\/public\/inline\/ACA_GUIDE_KY_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Coordination of Benefits Questionnaire", "date": "Mon Sep 09 13:52:21 UTC 2019", "link": "\/docs\/public\/inline\/COB_KY_01.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"2019 Webinars", "date": "Mon Sep 09 13:58:04 UTC 2019", "link": "\/docs\/public\/inline\/MO_WEBINARS_01.pdf", "formsLibrary": ["pro_guides"] ,"topics":[] } , { "title":"Provider Orientation Webinars", "date": "Mon Sep 09 14:00:13 UTC 2019", "link": "\/docs\/public\/inline\/MO_WEBINARS_02.pdf", "formsLibrary": ["pro_guides"] ,"topics":[] } , { "title":"New Provider Network Options", "date": "Mon Sep 09 14:02:50 UTC 2019", "link": "\/docs\/public\/inline\/MO_NETWORK_001.pdf", "formsLibrary": ["pro_guides"] ,"topics":[] } , { "title":"Health Insurance Exchange Quick Reference Guide - 2019", "date": "Mon Sep 09 14:05:55 UTC 2019", "link": "\/docs\/public\/inline\/ACA_GUIDE_OH_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Provider Claim Issue Escalation to Network Relations", "date": "Mon Sep 09 14:08:53 UTC 2019", "link": "\/docs\/public\/inline\/WI_CLAIMS_001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Anthem Wisconsin Member Identification Card Examples", "date": "Mon Sep 09 14:10:42 UTC 2019", "link": "\/docs\/public\/inline\/MEMBERID_WI_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Electronic Member ID Cards Quick Reference Guide", "date": "Mon Sep 09 14:12:30 UTC 2019", "link": "\/docs\/public\/inline\/MEMBERID_NY_001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"New York City Account - Claims Submission Guide", "date": "Mon Sep 09 14:14:14 UTC 2019", "link": "\/docs\/public\/inline\/NY_CLAIMS_GUIDE_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"New York State Health Insurance Program - Claim Submission Guide", "date": "Mon Sep 09 14:16:15 UTC 2019", "link": "\/docs\/public\/inline\/NY_CLAIMS_GUIDE_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Adaptive Behavior Assessment Request Form", "date": "Mon Sep 09 14:18:17 UTC 2019", "link": "\/docs\/public\/inline\/BehavioralHealth_VA_001.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Adaptive Behavior Treatment Request Form", "date": "Mon Sep 09 14:27:52 UTC 2019", "link": "\/docs\/public\/inline\/BehavioralHealth_VA_002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Preventive Health Guidelines", "date": "Fri Sep 06 17:51:35 UTC 2019", "link": "\/docs\/public\/inline\/17112VAMENBVA.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Access Online Reimittance Advices Via Availity", "date": "Mon Sep 09 14:32:37 UTC 2019", "link": "\/docs\/public\/inline\/AVAILITY_VA_0001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Virginia Affiliate Listing", "date": "Mon Sep 09 14:34:05 UTC 2019", "link": "\/docs\/public\/inline\/VA_AFFILIATES_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Virginia Standard Precertification\/Prior Authorization Requirements", "date": "Mon Sep 09 14:36:05 UTC 2019", "link": "\/docs\/public\/inline\/VA_PRECERT_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Precertification"] } , { "title":"2019 Individual & Small Employer Group Health Plans Quick Reference Guide", "date": "Mon Sep 09 14:37:31 UTC 2019", "link": "\/docs\/public\/inline\/CT_ACA_GUIDES_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Affordable Care Act"] } , { "title":"Commercial Risk Adjustment: Program Overview", "date": "Fri Sep 06 17:48:55 UTC 2019", "link": "\/docs\/public\/inline\/RISK_ADJUST_OVERVIEW.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Prior Authorization List", "date": "Tue Nov 12 17:37:33 UTC 2019", "link": "\/docs\/public\/inline\/CA_PA_List_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Provider Agreement Affiliates List", "date": "Fri Sep 06 18:07:53 UTC 2019", "link": "\/docs\/public\/inline\/CA_Affiliates_0001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Medical Management IVR Quick Reference Guide", "date": "Fri Sep 06 22:09:39 UTC 2019", "link": "\/docs\/public\/inline\/Med_Mgmt_IVR_0001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Enhancements made to avoidable ER program", "date": "Fri Sep 06 22:13:01 UTC 2019", "link": "\/docs\/public\/inline\/ER_PROGRAM_001.pdf", "formsLibrary": ["pro_guides"] ,"topics":[] } , { "title":"Guide to Provider Complaints and Appeals", "date": "Mon Sep 09 13:53:57 UTC 2019", "link": "\/docs\/public\/inline\/CE_CLAIMS_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"CAQH Solution: COB Smart FAQs", "date": "Mon Sep 09 14:04:22 UTC 2019", "link": "\/docs\/public\/inline\/COB_CE_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Patient Care"] } , { "title":"Coding Compensation Collaboration Policy", "date": "Fri Sep 06 17:31:11 UTC 2019", "link": "\/docs\/public\/inline\/COMP_CODING_CA_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Coding"] } , { "title":"Situations when Clinical Information is required for Claims Submission", "date": "Fri Sep 06 17:32:26 UTC 2019", "link": "\/docs\/public\/inline\/Policy_Procedure_CA_001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"Services that Require Precertification", "date": "Fri Sep 06 17:38:42 UTC 2019", "link": "\/docs\/public\/inline\/Policy_Procedure_CA_002.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"HCPCS and CPT Code Requirements for UB-04 Claims", "date": "Fri Sep 06 18:11:42 UTC 2019", "link": "\/docs\/public\/inline\/NE_CODES_0001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Coding"] } , { "title":"Prior Authorization Request: Inpatient or Outpatient", "date": "Tue Sep 10 20:12:25 UTC 2019", "link": "\/docs\/public\/inline\/PA_Request_NE_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Specialty Pharmacy Program Expansion - Level of Care Review FAQs", "date": "Wed Sep 18 14:07:06 UTC 2019", "link": "\/docs\/public\/inline\/SPEC_PHARM_CA_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Pharmacy"] } , { "title":"Access Online Remittance Advices via the Availity Web Portal", "date": "Fri Sep 06 17:45:59 UTC 2019", "link": "\/docs\/public\/inline\/AVAILITY_CA_0001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Digital Tools"] } , { "title":"Clinical Data Sharing", "date": "Wed Sep 25 18:26:12 UTC 2019", "link": "\/docs\/public\/inline\/CA_Admin_Data_Sharing.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Clinical Data Sharing", "date": "Wed Sep 25 18:25:40 UTC 2019", "link": "\/docs\/public\/inline\/NY_Admin_Data_Sharing.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Clinical Data Sharing", "date": "Wed Sep 25 18:18:12 UTC 2019", "link": "\/docs\/public\/inline\/CE_Admin_Data_Sharing.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Physician Extenders", "date": "Wed Sep 25 18:19:06 UTC 2019", "link": "\/docs\/public\/inline\/CE_Physician_Ext_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Resident Serivces", "date": "Wed Sep 25 18:21:31 UTC 2019", "link": "\/docs\/public\/inline\/CE_Res_Services_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Not Otherwise Classified (NOC) Non-Drug", "date": "Wed Sep 25 18:22:29 UTC 2019", "link": "\/docs\/public\/inline\/CE_NOC_DRUG_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Not Otherwise Classified (NOC) Drug", "date": "Wed Sep 25 18:23:03 UTC 2019", "link": "\/docs\/public\/inline\/CE_NOC_DRUG_02.pdf", "formsLibrary": 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"\/docs\/public\/inline\/NH_Formal_Audit_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Hospital Clinic Visit", "date": "Fri Sep 27 15:05:52 UTC 2019", "link": "\/docs\/public\/inline\/NH_Hospital_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Operating Room", "date": "Fri Sep 27 15:06:20 UTC 2019", "link": "\/docs\/public\/inline\/NH_Operating_room_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Outpatient Drugs", "date": "Fri Sep 27 15:06:54 UTC 2019", "link": "\/docs\/public\/inline\/NH_Outpatient_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Professional Provider Billing Guidelines", "date": "Fri Sep 27 15:08:11 UTC 2019", "link": "\/docs\/public\/inline\/NH_Billing_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policy"] } , { "title":"Recovery Room Charges", "date": "Fri Sep 27 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"formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Ask-the-Expert Town Hall 2019", "date": "Thu Oct 31 18:04:59 UTC 2019", "link": "\/docs\/public\/inline\/MO_Training_Educ_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"What's New 2020 Webinar Schedule", "date": "Thu Oct 31 18:02:55 UTC 2019", "link": "\/docs\/public\/inline\/MO_Training_Educ_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Provider Orientation Webinar Schedule", "date": "Thu Oct 31 17:59:10 UTC 2019", "link": "\/docs\/public\/inline\/MO_Training_Educ_03.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Anthem ePASS Weekly Webinar", "date": "Thu Oct 31 17:57:07 UTC 2019", "link": "\/docs\/public\/inline\/MO_Training_Educ_04.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Provider Maintenance Forms Guide", "date": "Fri Nov 16 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/PMG_FAQ_JR.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Anthem ePass Weekly Webinar ", "date": "Fri Mar 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/SHARED_FEP_00002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training & Education"] } , { "title":"AIM Quick Reference Guide", "date": "Wed Mar 28 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_WI_00206.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"History Record", "date": "Fri Dec 13 14:45:25 UTC 2019", "link": "\/docs\/public\/inline\/ped_adolescent_hist_rec_0002.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Medication List", "date": "Fri Dec 13 14:46:17 UTC 2019", "link": "\/docs\/public\/inline\/ped_adolescent_med_list_0003.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Problem List & Health maintenance", "date": "Fri Dec 13 14:47:05 UTC 2019", "link": "\/docs\/public\/inline\/ped_adolescent_prob_list_and_health_maint_0004.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Progress Notes", "date": "Fri Dec 13 14:52:39 UTC 2019", "link": "\/docs\/public\/inline\/ped_adoloscent_prog_notes_0005.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Physical Examination", "date": "Fri Dec 13 14:51:38 UTC 2019", "link": "\/docs\/public\/inline\/adult_physical_exam_0006.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Medication List", "date": "Fri Dec 13 14:47:49 UTC 2019", "link": "\/docs\/public\/inline\/adult_med_list_0007.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , { "title":"Problem List & Health maintenance", "date": "Fri Dec 13 14:48:43 UTC 2019", "link": "\/docs\/public\/inline\/adult_prob_list_and_health_maint_0008.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Patient Care"] } , {"title": "Abortion (Termination of Pregnancy)", "date": "Wed Aug 01 00:00:00 UTC 2018", "link": "da/inline/pdf/74763mupenmub.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Anesthesia Professional Services", "date": "Wed Oct 03 00:00:00 UTC 2018", "link": "da/inline/pdf/75703musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Assistant at Surgery Guidelines (Modifier 80/81/82/AS)", "date": "Mon Apr 03 00:00:00 UTC 2017", "link": "da/inline/pdf/67389musenmub.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Claim Requiring Additional Documentation", "date": "Fri Mar 01 00:00:00 UTC 2019", "link": "da/inline/pdf/71403musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Claim Submission – Required Information for Facilities (UB-92)", "date": "Wed Jul 19 00:00:00 UTC 2017", "link": "da/inline/pdf/68803musenmub_abcbs_02.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Claim Submission – Required Information Professional (CMS 1500)", "date": "Wed Jul 19 00:00:00 UTC 2017", "link": "da/inline/pdf/68803musenmub_2_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Claims Timely Filing", "date": "Thu Jan 15 12:00:00 UTC 2015", "link": "da/inline/pdf/62103musenmub_abcbs_02.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Code and Clinical Editing Guidelines", "date": "Mon Nov 09 00:00:00 UTC 2015", "link": "da/inline/pdf/76257mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Consultations", "date": "Fri Apr 20 00:00:00 UTC 2018", "link": "da/inline/pdf/72251musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Corrected Claims", "date": "Thu Jul 14 00:00:00 UTC 2016", "link": "da/inline/pdf/62103musenmub_abcbs_03.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Diagnoses Used for DRG Computation", "date": "Fri Nov 16 00:00:00 UTC 2018", "link": "da/inline/pdf/76078mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "DME Modifiers", "date": "Fri Oct 26 00:00:00 UTC 2018", "link": "da/inline/pdf/60069wpsenmub_abcbs_01.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Documentation Required for Proof of Timely Filing", "date": "Thu Sep 28 00:00:00 UTC 2017", "link": "da/inline/pdf/69457musenmub_abcbs_1.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Documentation Standards for Episodes of Care", "date": "Mon May 01 00:00:00 UTC 2017", "link": "da/inline/pdf/67389musenmub_abcbs_1.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "DRG Inpatient Facility Transfers", "date": "Mon Jun 05 00:00:00 UTC 2017", "link": "da/inline/pdf/68803musenmub_abcsb.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "DRG Newborn Inpatient Stays", "date": "Sat Sep 01 00:00:00 UTC 2018", "link": "da/inline/pdf/71136musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Drugs and Injectable Limits", "date": "Fri Oct 26 00:00:00 UTC 2018", "link": "da/inline/pdf/75441musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Durable Medical Equipment (Rent to Purchase)", "date": "Fri Oct 26 00:00:00 UTC 2018", "link": "da/inline/pdf/76066mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Emergency Service Reimbursement for Non-Participating Providers", "date": "Mon Nov 09 00:00:00 UTC 2015", "link": "da/inline/pdf/58979wpsenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Facility Take Home Drugs", "date": "Fri Apr 06 00:00:00 UTC 2018", "link": "da/inline/pdf/y0017_14_20753_i_002_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Facility Take-Home DME and Medical Supplies", "date": "Thu Sep 28 00:00:00 UTC 2017", "link": "da/inline/pdf/69372musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Global Surgical Package", "date": "Mon May 01 00:00:00 UTC 2017", "link": "da/inline/pdf/70739musenmub_abcbs_1.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Hysterectomy", "date": "Fri Aug 03 00:00:00 UTC 2018", "link": "da/inline/pdf/75080musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Inpatient Readmissions", "date": "Mon Apr 03 12:00:00 UTC 2017", "link": "da/inline/pdf/67389musenmub_abcbs_2.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Locum Tenens Physicians", "date": "Mon Aug 14 00:00:00 UTC 2017", "link": "da/inline/pdf/70568musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Maternity Services", "date": "Fri Jul 13 00:00:00 UTC 2018", "link": "da/inline/pdf/75978mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Maximum Units Per Day", "date": "Thu Jun 28 00:00:00 UTC 2018", "link": "da/inline/pdf/72241musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Medical Recalls", "date": "Fri Apr 06 00:00:00 UTC 2018", "link": "da/inline/pdf/70978musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 22: Unusual Procedural Service", "date": "Fri Dec 15 00:00:00 UTC 2017", "link": "da/inline/pdf/75890mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 24: Unrelated E&M Service", "date": "Fri Oct 26 00:00:00 UTC 2018", "link": "da/inline/pdf/76400mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 25 - Significant Separate E&M Services", "date": "Fri Oct 26 00:00:00 UTC 2018", "link": "da/inline/pdf/75802mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 26 and TC: Professional and Technical Component", "date": "Thu Sep 28 12:00:00 UTC 2017", "link": "da/inline/pdf/62103musenmub_abcbs_3.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 57: Decision for Surgery", "date": "Mon Aug 01 00:00:00 UTC 2016", "link": "da/inline/pdf/68803musenmub_abcbs_05.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 62: Co-Surgeons", "date": "Mon Aug 14 12:00:00 UTC 2017", "link": "da/inline/pdf/65975musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 63: Procedure on Infants less than 4kg", "date": "Mon Oct 03 00:00:00 UTC 2016", "link": "da/inline/pdf/76050mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 66: Surgical Team", "date": "Fri Nov 16 00:00:00 UTC 2018", "link": "da/inline/pdf/500771mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 76: Repeat Procedure by Same Physician", "date": "Wed Oct 03 00:00:00 UTC 2018", "link": "da/inline/pdf/75455musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 77: Repeat Procedure by Another Physician", "date": "Wed Oct 03 00:00:00 UTC 2018", "link": "da/inline/pdf/75456musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 78: Return to OR for Related Procedure PostOp", "date": "Wed Oct 03 00:00:00 UTC 2018", "link": "da/inline/pdf/75702musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier 91: Repeat Clinical Diagnostic Laboratory Test", "date": "Fri Nov 16 00:00:00 UTC 2018", "link": "da/inline/pdf/500790mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier LT/RT: Left Side/Right Side Procedures", "date": "Fri Aug 03 00:00:00 UTC 2018", "link": "da/inline/pdf/68803musenmub_abcbs_06.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Modifier Usage", "date": "Mon Aug 14 00:00:00 UTC 2017", "link": "da/inline/pdf/500557mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Multiple and Bilateral Surgery – Professional and Facility Reimbursement", "date": "Wed Oct 03 00:00:00 UTC 2018", "link": "da/inline/pdf/65974musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Multiple Delivery Services", "date": "Mon Oct 03 00:00:00 UTC 2016", "link": "da/inline/pdf/76025mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Multiple Radiology Payment Reduction", "date": "Thu Mar 15 12:00:00 UTC 2018", "link": "da/inline/pdf/70739musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Other Provider Preventable Conditions", "date": "Fri Dec 15 00:00:00 UTC 2017", "link": "da/inline/pdf/72996musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Portable/Mobile/Handheld Radiology", "date": "Fri Apr 06 00:00:00 UTC 2018", "link": "da/inline/pdf/67389musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Pre-admission Services for Inpatient Stays", "date": "Mon Apr 03 12:00:00 UTC 2017", "link": "da/inline/pdf/60069wpsenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Present on Admission Hospital Acquired Conditions", "date": "Thu Feb 11 00:00:00 UTC 2016", "link": "da/inline/pdf/61061musenmub_abcbs_01.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Preventive Medicine and Sick Visits on Same Day", "date": "Mon May 02 00:00:00 UTC 2016", "link": "da/inline/pdf/68803musenmub_abcbs_1.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Prosthetics & Orthotics", "date": "Wed Jul 19 00:00:00 UTC 2017", "link": "da/inline/pdf/62103musenmub_abcbs_01.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Reduced and Discontinued Services", "date": "Fri Apr 20 00:00:00 UTC 2018", "link": "da/inline/pdf/69457musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Claims with Charge Discrepancies ", "date": "Fri Oct 26 00:00:00 UTC 2018", "link": "da/inline/pdf/75706musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Eligible Billed Charges", "date": "Fri May 04 00:00:00 UTC 2018", "link": "da/inline/pdf/76288mupenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Reimbursement for Items under Warranty", "date": "Fri Jul 13 00:00:00 UTC 2018", "link": "da/inline/pdf/64443musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Reimbursement of Sanctioned and Opt-Out Providers", "date": "Wed Oct 03 00:00:00 UTC 2018", "link": "da/inline/pdf/66753capenabc_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Robotic Assisted Surgery", "date": "Wed Oct 03 00:00:00 UTC 2018", "link": "da/inline/pdf/70556musenmub_abcbs_01.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Scope of Practice", "date": "Thu Oct 26 00:00:00 UTC 2017", "link": "da/inline/pdf/62103musenmub_abcbs_06.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Services with Obsolete Codes", "date": "Fri Jul 13 00:00:00 UTC 2018", "link": "da/inline/pdf/70556musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Site of Service Payment Differential", "date": "Wed Jul 19 00:00:00 UTC 2017", "link": "da/inline/pdf/68803musenmub_abcbs_07.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Split-Care Surgical Modifiers", "date": "Wed Jul 19 00:00:00 UTC 2017", "link": "da/inline/pdf/62103musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Sterilization", "date": "Mon Aug 01 00:00:00 UTC 2016", "link": "da/inline/pdf/61061musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Transportation Services", "date": "Wed Aug 01 00:00:00 UTC 2018", "link": "da/inline/pdf/68803musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Emergency Department: Level of Evaluation and Management Services", "date": "Tue May 07 12:00:00 UTC 2019", "link": "da/inline/pdf/501147mupenmub.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Distinct Procedural Services (Modifiers 59 XE XP XS XU)", "date": "Thu Aug 31 00:00:00 UTC 2017", "link": "da/inline/pdf/69670musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } , {"title": "Unlisted Unspecified or Miscellaneous Codes", "date": "Fri Jul 13 00:00:00 UTC 2018", "link": "da/inline/pdf/69445musenmub_abcbs.pdf", "formsLibrary": ["[pro_reimbursement]"], "topics": ["Medicare Advantage"] } ] }