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News & Announcements

Electrical stimulation device to require prior authorization
Quarterly pharmacy formulary change notice effective May 1, 2018
Prior authorization requirement update for Mylotarg
Q4 Medical Policies and Clinical Utilization Management Guidelines Updates
Meningococcal vaccine update
ICS Pharmacy Formulary Change Notice
Medical Policy update - Hyaluronan Injections
2018 Utilization Management Affirmative Statement
Eight injectable drugs will require prior authorization
AIM Musculoskeletal Guidelines
Elotuzumab to require prior authorization
Welcome to the provider network family
Levoleucovorin calcium, elosulfase alfa, histrelin acetate, idursulfase and fulvestrant to require prior authorization
New Pharmacy Electronic Prior Authorization Request Tool Effective April 1, 2018
Age limits pharmacy formulary change notice effective February 1, 2018
Quarterly pharmacy formulary change notice effective February 1, 2018
Effective January 1, 2018, providers will be required to use ProView for credentialing
Alliance Behavioral Heath Inpatient and Outpatient Benefits
New review process for not otherwise classified drug codes
McKesson criteria disclosure
DHCF Open House Flier
Provider Orientation Invitation
UPDATE No/Late Notification Process
Transplant Service Request Instructions
February 2017 UPDATE to Medical Policies and Clinical Utilization Management Guidelines
Genetic Testing Services
UPDATE to Medical Policies and Clinical Utilization Management Guidelines
Prior Authorization Update for Custom Shower Chairs

Provider Self-Service

Do more online through Provider Self-Service!

  • File and check the status of medical claims
  • Verify eligibility
  • Request precertification via the Interactive Care Reviewer (ICR)
  • Conduct an inquiry on the status of any precertification request via ICR
  • For more information on ICR such as features, support or training go to
    ICR-Help
  • Submit a Pharmacy Prior Authorization Request
  • And much more!

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Provider Resources & Documents
expand Behavioral Health
Concurrent Review Form
Discharge Form
Mental Health Outpatient Treatment Report Form
PRTF Treatment Review Form
expand Claims Submission and Reimbursement Policy
Electronic Data Interchange (EDI)
expand Clinical Practice Guidelines
expand Disease Management Centralized Care Unit
About DMCCU
How to Use DMCCU
expand EPSDT
EPSDT Reminder Program
expand Forms
NCC Prior Authorization Form
PCP Change Form - Spanish Version
expand ICD-10
ICD-10
expand Manuals & QRCs
Medicaid Provider Manual
expand Maternal Child Program
Newborn Notification Delivery Form
Zika Virus
Obstetrical Authorization & Initial Assessment
expand Medical Management Model
Care Management
Medical Management Model
expand Newsletters - Current
2017 December Provider Newsletter
April 2018 Provider Newsletter
expand Pharmacy
Synagis Prior Authorization Form
Medicaid Preferred PDL
expand Provider Training
Availity Training
expand Quick Tools
Medical Policies
expand Vendor/Partner Links & Information
DentaQuest
AIM (Diagnostic and Imaging Service Authorizations)
ESI Locator Tool
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