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Provider Manual
Table of Contents
Quick Reference
Introduction
Member
Coverage Arrangements
Primary Care Practitioner
Specialty Care Practitioner
OB/GYN Services
Policies and Procedures
Hospital Services
Referrals and Authorizations
Claims and Billing
Appeals and Grievances
Model of Care
Preventive Health
Credentialing
Drug List & Information
Drug List
Drug Safety Information
Drug Recall
Forms & Reference Materials
Forms
Physician In-service Materials
Gateway at a Glance
Adjustment Codes
Helpful Links
Fraud, Waste and Abuse Training
Provider News & Updates
Provider News
Newsletters & Newsflashes
Provider Satisfaction Survey
Medicare Assured
®
HMO
Quality Improvement
Clinical Guidelines
Complex Case Management
Patient Safety & Wellness
Immunizations
Provider Updates
July 2010
Impact of Substance Use on Pregnant Women and Their Newborns
July 2010
FAQ's for Credentialing
April 2010
New Claims Mailing Addresses
March 2010
Fraud and Abuse Training
October 2009
Antiviral Medication Update
October 2009
Important H1N1 Influenza Update
August 2009
New Hours of Operation
June 2009
CMS Alert
October 2008
DRG Grouper Billing Guidelines; Change to Utilization Management’s Medicaid 800 Line and Change to Utilization Management’s Process for Voicemail Messages
July 2008
Important Information About (POA) Present on Admission Indicator Reporting; Change in Maternity Outcome Authorization Form; Third Party Liability
March 2008
Important Change to Gateway Health Plan
®
's Authorization Criteria
Medicare Assured
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Last Updated:
1/1/2010