Forms
- Authorization to Use and Disclose PHI
- Care Management Referral
- Coordination of Benefits
- Medicare Appointment of Representative
- Medicare Grievance and Appeal
- Medimpact Claim
- Member Reimbursement Form (Medicare)
- Pharmacy Prior Auth Request (PAR)/Exception Request
- Prescription Drug Coverage Determination Request
- Request for Redetermination of Medicare Prescription Drug Denial
- Transition of Care/Continuation of Care Request
- UM Prior Authorization Request
Documents
Links
- Accessing Your Health Information Using Third Party Apps
- Affirmative Statement About Incentives
- Affordable Connectivity Program
- Best Available Evidence
- Denver Parks and Recreation Membership
- Request Copy of Provider or Pharmacy Directory
- LIS Premium Subsidy
- Medicare Coverage Decisions, Appeals and Grievances
- Medicare Disenrollment
- Medicare Enrollment Instructions
- Member Newsletter
- Member Portal
- Member Rights & Responsibilities
- Transportation to Medical Visits
- Wellness Blog
- Your Dental Benefits
- Your Hearing Benefits
- Your Vision Benefits