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FAQ
2025 Marketplace Provider Manual
2024 Marketplace Provider Manual
Prior Authorization LookUp Tool
2025 Prior Authorization Guide - Marketplace - Effective 01/01/2025
Q4 2024 Prior Authorization Guide - Marketplace - Effective 10/01/2024
Q3 2024 Prior Authorization Guide - Marketplace - Effective 07/01/2024
Q2 2024 Prior Authorization Guide - Marketplace - Effective 04/01/2024
Q1 2024 Prior Authorization Guide - Marketplace - Effective 01/01/2024
Q1 2024 Prior Authorization Matrix - Marketplace - Effective 01/01/2024
Claims Dispute Request Form
No Surprises Act - Independent Dispute Resolution Form (Non-Contracted Providers only)
2nd Quarter PA Guide and Matrix Fax Blast
Drug Prior Authorization Form
MI-Alternative Level of Care Authorization Form
MI-OB Notification Form
Physician Office Laboratory Tests
Provider Request to Change PCP Form
Community Connector Referral Guide
CAHPS Provider Brochure
Notification of Pregnancy
Provider Change Form Requirements and Guidelines
Provider Change Form
Synagis Authorization Form
MI Interpreter Request Form
Health Education Referral Form
Home Care FAQ
Healthcare Services Leadership Contact List
Authorized Representative Designation
2018 Cultural Competency Training Attestation
2018 Prior Authorization Matrix - Effective 10/1/2018
2018 Prior Authorization Guide - effective 10/01/2018
2018 Prior Authorization Guide - effective 06/01/2018
2018 Prior Authorization Matrix - effective 06/01/2018
2018 Prior Authorization Matrix - effective 01/01/2018
2018 Prior Authorization Guide - effective 03/01/2018