Our manual contains dental and medical policy and procedure information that can be used as a day-to-day reference by our providers and their staff.
Updates to manual sections are posted at the beginning of the month in which they occur and a notification is included in our newsletter, The Connection℠. Our newsletter is published in February, April, June, August, October and December. Sign up to receive our newsletters via email. Please review new content promptly to ensure you have the most current information.
Learn more about us, view our Code of Business Conduct policy or our confidentiality information and requirements.
2/2023 | Updated Responsibilities of Participation section | |
3/2021 | Added link to member authorization to disclose information | |
12/2022 | Added requirement to submit provider appeals via Availity Essentials effective March 1, 2023 | |
4/2023 | Updated treatment plans section | |
8/2023 |
| |
8/2019 |
| |
2/2022 | Revised the Documentation Requirements section | |
8/2023 | Added nuclear medicine imaging to the list of services included in our radiology program | |
10/2022 | Added Medicare Star Ratings information | |
Medicare Advantage Compliance Requirements (PDF) Note: Our Medicare Advantage providers must comply with the requirements in this section, in accordance with the Medicare Advantage Provider Compliance Addendum. | 4/2022 | Updated regulatory references |
8/2021 | Updated with our current contact information | |
2/2023 | Added information about fragmented/split professional billing | |
12/2020 | Added this new section that includes the requirements for providers who care for members on our Individual and small group products | |
4/2022 | Added information about provider education | |
4/2023 | Updated treatment plans section |