Changes to Provider Center sections and names

We have made two changes to the organization of the Provider Center that we hope will help you find information faster.

Responsibilities & standards section

This section has a new name, Requirements & responsibilities. We think this more accurately reflects the information there. The section includes:

  • Contracting
  • Credentialing
  • NPI numbers
  • Electronic payments setup
  • Physician status (Locum tenens, moving your practice, terminating your contract)
  • Opening or closing to new patients
  • Availability standards (response times, hours, locations)
  • Changes to address or staff
  • Provider-patient relationship (new vs. established patients, member PCP changes, PCP reassignment, discharge, transfer medical records, extension of care)
  • Medical and office records (signature requirements, documentation in EMRs, documentation standards)
  • Audits (DRG, APC, SIU, facility)
  • Site visits and review standards
  • Confidentiality standards
  • Medicaid patient treatment requirements
  • Medicare patient treatment requirements
  • Fraud, waste and abuse policy, laws and compliance
  • Utilization management program, with InterQual® criteria

Go to the Requirements & responsibilities section.

Your online account section

We've pulled this section out from the newly renamed Requirements & responsibilities section to stand on its own. Now you'll have a link at the bottom of every page to "Your online account" if you want to know about how to use provider online tools, change your password, or use your secure Mailbox.

Go  to Your online account information now.