2023-2024 Annual Provider Notification

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2023-2024 Annual Provider Notification

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See our 2024 Network and Benefit Plans.

What to Expect for 2024 & 2023 Year in Review

Please review and share this notice and the following materials with your clinicians and staff. This streamlined recap of 2023 guidance and what you’ll need to know for 2024 will help you care for your patients and help us work better together.

We have made some significant improvements to our provider portal to help you get faster preauthorization determinations.

As always, visit our Provider Manual for guidance and reference on regulatory, policy, and accreditation requirements (such as provider rights, member rights and responsibilities, availability of criteria, and pharmacy procedures). Here are some of the most visited sections within the Provider Manual:

*Members assigned to HealthCare Partners and SOMOS will continue to follow their administrative processes and will need to submit Emergency Room admission/newborn notifications directly to them. Our vendor partners who manage our Utilization Management Programs will continue to use their own websites and provider portals for transactions.

 

Key Things To Know

Your Resources

  • Provider Portal

    Visit frequently asked questions, videos, and user guides for assistance.

  • Provider Manual

    View your administrative responsibilities, contract agreements, and how to help members navigate our delivery systems.

  • Provider Toolkit

    Guides and quick references to help with the administration of our plans.

  • Provider Newsletter

    The Office Visit is our monthly newsletter. See editions you may have missed.

  • MD Perspectives

    Hear from our Medical Directors on timely health topics.

  • Member Materials

    Find materials you can give your members in support of your care plans.

  • Neighborhood Care

    Let us help you help our members. See how we can support you.

Help and Support

Check frequently asked questions and answers before contacting Customer Service.

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