{ "forms":[ { "title":"Practitioner Credentialing Rights", "date": "Thu Nov 12 16:48:54 UTC 2020", "link": "\/docs\/public\/inline\/practitioner-credentialing-rights-1218.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Join Our Network"] } , { "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":"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": 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"\/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 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"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": 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"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 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["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 12:00:00 UTC 2018", "link": "\/docs\/public\/inline\/P_DENT_0035.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Dental","Contracting & Updates"] } , { "title":"Commerical Measurement Period Handbook", "date": 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["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": 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"\/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) 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,"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 (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","Other Forms"] } , { "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": "Tue Jun 23 12:00:00 UTC 2020", "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":"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":"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":"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":"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":"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":"Qualified Autism Provider Certification - Intensive Level Services", "date": "Thu Feb 13 17:38:07 UTC 2020", "link": "\/docs\/public\/inline\/WI_CERT_00001.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Qualified Autism Provider Certification - Non-Intensive Level Services", "date": "Thu Feb 13 21:32:33 UTC 2020", "link": "\/docs\/public\/inline\/WI_CERT_00002.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Qualified Autism Provider Certification – Outpatient Mental Health Clinic", "date": "Thu Feb 13 23:34:28 UTC 2020", "link": "\/docs\/public\/inline\/WI_CERT_00003.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Qualified Autism Provider Certification - Paraprofessional", "date": "Thu Feb 13 23:44:39 UTC 2020", "link": "\/docs\/public\/inline\/WI_CERT_00004.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Behavioral Health"] } , { "title":"Qualified Autism Provider Certification - Occupational Therapist and Speech Therapist", "date": "Thu Feb 13 23:15:01 UTC 2020", "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":"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":"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"] } , { 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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":"Electronic Member ID Cards - Dental Quick Reference Guide", "date": "Mon Dec 30 17:16:30 UTC 2019", "link": "\/docs\/public\/inline\/DENT_NY_00002.pdf", 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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":"Provider Appeals", "date": "Fri Jun 12 19:11:32 UTC 2020", "link": "\/docs\/public\/inline\/CLAIMS_CO_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims"] } , { "title":"Provider Appeals", "date": "Mon Jun 15 18:48:39 UTC 2020", "link": "\/docs\/public\/inline\/CLAIMS_CE_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims"] } , { "title":"Provider Appeals", "date": "Thu Jun 11 14:25:42 UTC 2020", "link": 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["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": "\/docs\/public\/inline\/pw_e179664.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Detailed Explanation of Non-Coverage (EBCBS)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179667.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Medical Coverage (EBCBS)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179669.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Integrated Denial Notice – Notice of Denial of Payment (EBCBS)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179671.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Notice of Medicare Non-Coverage (EBCBS)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e179665.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Medicare Advantage Precertification Request (EBCBS)", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e168695.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Inquiry\/Refund\/Adjustment Form", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_e195395.doc", "formsLibrary": ["pro_forms"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Inquiry\/Refund\/Adjustment Form Instructions", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_a031291.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"ABCBS Medicare Advantage Member ID Card Sample", "date": "Mon Jul 01 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/pw_g372188.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Medicare & Medicaid"] } , { "title":"Provider Appeals", "date": "Thu Jun 11 14:25:45 UTC 2020", "link": "\/docs\/public\/inline\/CLAIMS_CA_00001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Claims & Appeals"] } , { "title":"WI Network Relations", "date": "Mon Jan 25 22:02:10 UTC 2021", "link": "\/docs\/public\/inline\/WI_CONTACT_00003_jr.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Provider Letter of Intent", "date": "Wed Jan 27 22:39:54 UTC 2021", "link": "\/docs\/public\/inline\/WI_CONTACT_00002_jr.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Customizations to MCG Care Guidelines 23rd Edition", "date": "Thu Jun 06 18:30:00 UTC 2019", "link": "\/docs\/public\/inline\/UNICARE_MCG_0001.pdf", "formsLibrary": ["pro_guides"] ,"topics":[""] } , { "title":"Anthem EFT ERA Brochure", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_001.pdf", "formsLibrary": 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"\/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 TRF New Codes", "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 Example", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_009.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training"] } , { "title":"Recoupment Remit Example", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_0010.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training"] } , { "title":"Refund Application Examples", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_0011.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training"] } , { "title":"2019 Subject Specific Webinars", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_0012.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training & Education"] } , { "title":"Local Member Medical Record Sample Letter", "date": "Fri Aug 23 12:00:00 UTC 2019", "link": "\/docs\/public\/inline\/WI_TRAIN_EDUC_0015.pdf", "formsLibrary": ["pro_forms"] ,"topics": ["Training"] } , { "title":"Affiliated Companies", "date": "Mon Jan 11 20:11:56 UTC 2021", "link": "\/docs\/public\/inline\/ALL_Affiliates_0001.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Contracting & Updates"] } , { "title":"Specialty Pharmacy Program Expansion - Level of Care 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"\/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":"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":"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":"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":"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":"HCPCS and CPT Code Requirements for UB-04 Claims", "date": "Thu Sep 10 19:35:58 UTC 2020", "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": "Thu Apr 02 14:40:31 UTC 2020", "link": "\/docs\/public\/inline\/CA_Admin_Data_Sharing.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative 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"link": "\/docs\/public\/inline\/CE_Admin_Data_Sharing.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Physician Extenders", "date": "Thu Apr 02 14:40:46 UTC 2020", "link": "\/docs\/public\/inline\/CE_Physician_Ext_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Resident Services", "date": "Thu Apr 02 14:40:50 UTC 2020", "link": "\/docs\/public\/inline\/CE_Res_Services_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Not Otherwise Classified (NOC) Non-Drug", "date": "Thu Apr 02 14:40:33 UTC 2020", "link": "\/docs\/public\/inline\/CE_NOC_DRUG_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Not Otherwise Classified (NOC) Drug", "date": "Thu Apr 02 14:40:34 UTC 2020", "link": "\/docs\/public\/inline\/CE_NOC_DRUG_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Locum Tenens", "date": "Thu Apr 02 14:40:35 UTC 2020", "link": "\/docs\/public\/inline\/CE_Locum_Tenens_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Timely Filing for Adjustments & Corrected Claims", "date": "Thu Apr 02 14:40:48 UTC 2020", "link": "\/docs\/public\/inline\/ME_Timely_Filing_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Timely Filing for Adjustments & Corrected Claims", "date": "Thu Apr 02 14:40:30 UTC 2020", "link": "\/docs\/public\/inline\/NH_Timely_Filing_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Clinical Data Sharing", "date": "Thu Apr 02 14:40:49 UTC 2020", "link": "\/docs\/public\/inline\/NV_Admin_Data_Sharing.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Capital Equipment", "date": "Thu Apr 02 14:40:36 UTC 2020", "link": "\/docs\/public\/inline\/NH_Cap_Equiment_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Formal Audit", "date": "Thu Apr 02 14:40:37 UTC 2020", "link": "\/docs\/public\/inline\/NH_Formal_Audit_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Hospital Clinic Visit", "date": "Thu Apr 02 14:40:26 UTC 2020", "link": "\/docs\/public\/inline\/NH_Hospital_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Operating Room", "date": "Thu Apr 02 14:40:27 UTC 2020", "link": "\/docs\/public\/inline\/NH_Operating_room_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Outpatient Drugs", "date": "Thu Apr 02 14:40:28 UTC 2020", "link": "\/docs\/public\/inline\/NH_Outpatient_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Professional Provider Billing Guidelines", "date": "Thu Apr 02 14:40:39 UTC 2020", "link": "\/docs\/public\/inline\/NH_Billing_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Recovery Room Charges", "date": "Thu Apr 02 14:40:44 UTC 2020", "link": "\/docs\/public\/inline\/NH_Recovery_Room_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Room & Board - Included Charges", "date": "Thu Apr 02 14:40:40 UTC 2020", "link": "\/docs\/public\/inline\/NH_Room_and_Board.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Services Incidental to Admission", "date": "Thu Apr 02 14:40:41 UTC 2020", "link": "\/docs\/public\/inline\/NH_Admission_services_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Administrative Policies"] } , { "title":"Ask-the-Expert Town Hall Webinar Invitation", "date": "Fri Oct 18 16:09:50 UTC 2019", "link": "\/docs\/public\/inline\/MO_TOWN_HALL_2019.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"2021 FEP Precertification Requirements", "date": "Wed Feb 03 21:57:37 UTC 2021", "link": "\/docs\/public\/inline\/CA-2021_FEP_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"2021 FEP Precertification Requirements", "date": "Wed Feb 03 21:57:28 UTC 2021", "link": "\/docs\/public\/inline\/CO-2021_FEP_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"2021 FEP Precertification Requirements", "date": "Wed Feb 03 21:57:29 UTC 2021", "link": "\/docs\/public\/inline\/CT-2021_FEP_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"2021 FEP Precertification Requirements", "date": "Wed Feb 03 21:57:38 UTC 2021", "link": "\/docs\/public\/inline\/GA-2021_FEP_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"2021 FEP Precertification Requirements", "date": "Wed Feb 03 21:57:21 UTC 2021", "link": 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"\/docs\/public\/inline\/2019_FEP_14.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"2021 FEP Precertification Requirements", "date": "Wed Feb 03 21:57:31 UTC 2021", "link": "\/docs\/public\/inline\/OH-2021_FEP_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Prior Authorizations"] } , { "title":"Open the Town Hall Webinar Schedule", "date": "Mon Feb 10 16:31:46 UTC 2020", "link": "\/docs\/public\/inline\/MO_Training_Educ_01.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Open the What's New Webinar Schedule", "date": "Tue Dec 08 20:54:16 UTC 2020", "link": "\/docs\/public\/inline\/MO_Training_Educ_02.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Open the Provider Orientation Webinar Schedule", "date": "Mon Feb 10 16:30:16 UTC 2020", "link": "\/docs\/public\/inline\/MO_Training_Educ_03.pdf", "formsLibrary": ["pro_guides"] ,"topics": ["Training & Education"] } , { "title":"Open the ePASS Webinar Schedule", "date": "Mon Feb 10 16:33:09 UTC 2020", "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":"Commercial Medical Record Standards", "date": "Mon Mar 01 22:03:14 UTC 2021", "link": "\/docs\/public\/inline\/med_record_review_process_0001.pdf", 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