Prior Authorization (PA)

Therapy Forms

Medical Necessity Denial Letters

Hospital Preadmission Denial Notice

Detailed Notice of Discharge

Notice of Medicare Non-coverage: Home Health

Notice of Medicare Non-coverage: Skilled Nursing Facility (SNF)

Notice of Denial of Medical Coverage: Skilled Nursing Facility (SNF)

Notice of Denial of Medical Coverage: Hospital Observation

Medicare Outpatient Observation Notice

Provider Portal

Login to check eligibility and claim status and view explanation of payment (EOP) statements, view quarterly CMS verification updates for the directory listings and annual Facility Operations Form updates. View the ACH provider guide here.

We now have two provider portals. Please select the appropriate link –

  • If the member's number starts with 70, 80, or 90, 
    login here.
  • If the member's number starts with 713 or 714,
    login here.