Provider Forms and Documents

Members enrolled in our HMO and POS products are required to select a Primary Care Physician (PCP) who acts as the coordinator of care for the patient. Members must contact their PCP prior to making appointments with specialty providers. Upon assessment of the patient needs, the PCP may find it appropriate to refer the patient to other participating specialty providers.

The Health Plan contracts with providers in order to obtain quality care at an affordable price. This enables us to contain premium increases to our membership. All services that can be properly performed by Health Plan providers must be referred in-plan. Services, which are not available through this in-plan network require preauthorization via an out-of-plan referral.

In addition to the Provider Manual and that training that accompanies it, The Health Plan Customer Service Represenatives are always available to assist in any way possible by calling 1.800.624.6961/740.695.7901 in St. Clairsville and 1.888.830.4370/740.330.4370 in Massillon. Listed below are links to help you access other helpful resources and documents.