Resources

Medication PA form (Pharmacy via Express Scripts)

Behavioral Health PA Form (2020)

Effective 12/15/19

Notification/Prior Approval Form (2020)

Updated 7/1/20

Medication PA Form (Medical via Health Options) (2020)

Effective 1/1/20

Therapies Prior Approval Form (2020)

Updated 7/1/20

Claims Reconsideration Form

Provider Appeal Form

Billing Information Form

Please note that the print/email buttons in this document may not work with your browser or PDF reader. You may submit this completed form via email to dataintegrity@healthoptions.org.

Electronic Fund Transfer (EFT) & Electronic Remittance Advice (ERA) Authorization Agreement

Provider Credentialing and Change Form

Member Rights and Responsibilities

Appeal Rights and Information

Use this guide to understand your rights and options in the event that a service is denied.

Official Coding Guidelines Related to COVID-19

This link provides the CDC's official coding guidelines related to COVID-19.

Behavioral Health Prior Approval & Notification Requirements - Quick Reference Guide (2020)

Effective 12/15/19

Prior Approval Overview & Notification (2020)

Updated 7/1/20

Medical Prior Approval (2020)

Updated 7/1/20

eviCore Medical Prior Approval Requirements - Quick Reference Guide (2020)

Updated 7/1/20

Medications Prior Approval & Notification Requirements - Quick Reference Guide (2020)

Effective 1/1/20

Durable Medical Equipment Prior Approval Requirements - Quick Reference Guide (2020)

Updated 7/1/20

Health Options Online Provider FAQs

Effective 2/26/19

Common Coding and Documentation

Key points for providers on correct coding.

HEDIS Measurement Definitions

Quality Improvement Program and Provider Expectations

This summary of Health Options Quality Improvement Program includes the goals and objectives of our program and expectations of providers to participate in quality activities.

Risk Adjustment: Key Points for Providers

Risk adjustment coding tips to improve clinical documentation for providers.

Forms

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