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Network Operations and Care Delivery Management

Provider Network
    Provider Communications (05-09)
    Primary Care Providers (09-16)
    Specialists (09-16)
    Local Care Units (LCUs) (09-16)
    Facility Care Services (05-17)
    Selected Provider Networks (09-16)
    Clinical Credentialing & Recredentialing (08-17)
    Facility Credentialing & Recredentialing (07-17)
    Practice Site Standards (06-17)
    Limited Service Provider - Retail Medicine (11-16)
    Urgent Care & Walk-In Providers (11-16)
Provider Performance Standards & Expectations
    Home DME & Oxygen/Respiratory Care (06-13)
    Home Health Care (06-13)
    Hospice Care (06-13)
    Inpatient Acute Rehabilitation Hospitals,  
     Sub-Acute & Skilled Nursing Care Facilities (06-13)
    Effective through 08/31/17: Sleep Diagnostic and  
     Therapy Providers (09-15)

Care Delivery Programs
    Care Management (03-15)
    Centers of Excellence Program (11-15)
    Clinical Decisions (06-17)
    Denials and Adverse Determination (06-17)
    Prescription Drug Management (09-17)
    Utilization Management (11-15)

Forms
    NPI Submission
    Provider Change Form & Form Information (11-17)
Uniform Credentialing Applications
    HCAS Provider Enrollment Form
(**Important note for behavioral health providers**)

Resources
    Clinical Guidelines
    Disease Management Programs
    Provider Directory
    Quality Program Initiatives
    Technology Assessment Program

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Important Information About This Manual
Quick Reference Guide by Service & Product
Key Contacts