Pharmacy
- Pharmacy Prior Auth Request (PAR)/Exception Request Form
- Pharmacy Prior Authorization Request Form
- Medicare Prescription Drug Coverage Determination Request Form
- Upload a Pharmacy Prior Authorization Form Here
- Commercial Prior Authorization Criteria
- Medicaid / CHP+ Prior Authorization Criteria
- Commercial Step Therapy
- Medicaid / CHP+ Step Therapy
- Medicare Prior Authorization Criteria
- Elevate Prior Authorization Criteria
- Medicare Step Therapy
Utilization Management
Provider Relations & Credentialing
- Become a Provider
- CAQH Credentialing
- Letter to Providers
- Member Rights & Responsibilities
- Provider Newsletters
- Notification of Practitioner Rights
- EFT Letter & Request Form
- W-9
- Billing Information
- 835 Enrollment
- RTE Transactions
- Medicare Waiver of Liability Form
- Affirmative Statement About Incentives