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Medicaid

	Provider Manual

Table of Contents

Quick Reference

Coverage Arrangements

Laboratory Services

Primary Care Practitioner

Growing Up With Gateway^SM

Specialty Care Practitioner

OB/GYN Services

Policies and Procedures

Hospital Services

Referrals and Authorizations

Claims and Billing

Adjustment Codes

Complaints and Grievances

Preventive Health


	Drug List and Information

Step Therapy Protocols

Prior Authorization

Drug Safety Information

Medication Coverage

Pharmacy and Therapeutics Committee


	Forms & Reference Materials

Expand EPSDT Periodicity Schedule

EPSDT Periodicity Schedule

Fraud and Abuse Policy

Gateway at a Glance


	Provider News & Updates

Expand Provider News

Expand Newsletters & Newsflashes

Newsletters & Newsflashes

Provider Satisfaction


	Medicaid Quality Improvement


	Patient Safety & Wellness

Expand Immunization Info

Immunization Info

Expand Patient Safety

Provider Updates

December 2009	New Billing Requirements for EPSDT Screening Services
October 2009	Antiviral Medication Update
October 2009	Important H1N1 Influenza Update
August 2009	New Hours of Operation
June 2009	CMS Alert
May 2009	Flu Vaccine
October 2008	Exciting Changes to Outpatient Surgery Prior Authorization Requirement; DRG Grouper Billing Guidelines; Change to Utilization Management’s Medicaid 800 Line and Change to Utilization Management’s Process for Voicemail Messages; Change to Medicaid Related Readmission Policy
August 2008	Identification and Treatment of Pregnant, Opioid-Dependent Women and Their Newborns.
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
November 2007	Managed Care Organizations' Providers are Required to Register their NPI Numbers with DPW!
April 2007	Vaccine Update
March 2007	Important information regarding Medicaid Voluntary Managed Care Counties

Gateway to Physician Excellence

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Gateway to Physician Excellence

Last Updated: 1/1/2010