Find a Provider

Search for a provider, specialist or hospital in your location. Download a simple directory for you to have on hand when you need it.

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Compliance Fraud, Waste and Abuse (FWA)

Compliance, FWA, D-SNP and Cultural Competency Training

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Advance Directive Information

In 1991, the federal government passed the Patient Self-Determination Act (PSDA), guaranteeing individuals the right to make health care decisions and indicate preferences regar

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All pharmacy submissions can be made electronically through our pharmacy benefit manager (PBM), Express Scripts.

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Electronic Transactions

The Health Plan provides the ability for a practitioner/facility to submit a file for eligibility information and benefits for our members through their designated clearinghouse or directly to their office as instructed. You can also access our billing and EDO authorization form.

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The Health Plan has a certified staff of professionals who continuously monitor trends and industry standards. Our staff includes registered nurses (RN) and certified coders.

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The Health Plan utilizes established guidelines provided by governing bodies of the federal and state levels of government to process medical claims.

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The Health Plan provides the HIPAA 835 transaction set for electronic vouchers.

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Physician Case Management Referral

The Health Plan has registered nurses that are certified case managers to coordinate health care services for members with catastrophic illnesses, injuries, or behavioral health problems.

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