Utilization Management
- Provider Tips - Applied Behavior Analysis (ABA)
- Provider Tips - Authorization Submissions
- Provider Tips - Behavioral Health
- Provider Tips - Breast Pumps
- Provider Tips - Cochlear Implants
- Provider Tips - DHMP Medicaid Choice Attribution Process
- Provider Tips - Early Intervention Services (EIS)
- Provider Tips - Home Health Care
- Provider Tips - Neuropsychology Testing
- Provider Tips - Newborn Enrollment
- Provider Tips - Outpatient Therapy
- Clinical Coverage Determination Criteria
- Adult Orthotics and Prosthetics Form
- Transition of Care / Continuation of Care Request Form
- Medicaid Provider Forms
- Oral/Enteral Nutrition Form
- Oxygen Request Form
Pharmacy
- Pharmacy Prior Auth Request (PAR)/Exception Request
- Upload a Pharmacy Prior Authorization Form Here
- Medicare Prescription Drug Coverage Determination Request Form
- Commercial Prior Authorization Criteria
- Medicare Prior Authorization Criteria
- Medicare Step Therapy
- Medicaid / CHP+ Prior Authorization Criteria
- Elevate Prior Authorization Criteria
Provider Relations & Credentialing
- Become a Provider
- Provider Orientation
- Notification of Practitioner Rights
- CAQH Credentialing
- Policy for Selection and Retention of Providers
- Letter to Providers
- Member Rights & Responsibilities
- Affirmative Statement About Incentives
- Medicare Advantage Risk Adjustment Training for Providers
- Real Time Eligibility (RTE) Transactions
- W-9
- Provider Payment Options
- Provider Newsletters
- DHMP Member Identification Card
- Provider Portal Attestation Form
Grievances And Appeals
- CHP+ Grievances and Appeals
- Medicaid Grievances and Appeals
- Medicare Exceptions Grievances and Appeals
- Provider Request for Dispute Resolution Form
- Designated Personal Representative (DPR) Form
- CHP+ Complaint and Appeal Form
- Commercial Products Complaint and Appeal Form
- Medicaid Complaint and Appeal Form
- Medicare Appeal and Grievance Form
- Medicare Waiver of Liability Form
- Independent External Review of Carrier's Adverse Determination