Scott & White Health Plan

• Provider Manual
  • Table of Contents
  • Provider Orientation/Education Checklist
  • Mission Statement
  • Preface
  • Confidentiality Statement
  • Members Rights and Responsibilities
  • Member Compaint & Appeal Procedure
  • SeniorCare Complaint & Appeal Procedure
  • MyPlan Provider Module
  • Member Eligibility Verification Procedures
  • Member Identification Card
  • Primary Care Physician Program
  • Physician's Office DME/Supplies Policy
  • Physician Referral Procedures
  • Directory to Plan Providers
  • Preauthorization/Authorization of Services
  • Hospitalization Procedures
  • Utilization Management Plan
  • Technology Assessment Program
  • Physician Reports
  • Quality Improvement Program
  • Clinical Guidelines
  • RQI Program Description
  • RQI Provider Portal
  • RQI Clinical Guidelines
  • RQI CPT Codes - 2010
  • AIM Portal-Cardiac Results Capture Process
  • RQI Expanded Cardiac Services FAQs
  • Laboratory
  • Pharmacy Services
  • SeniorCare Program
  • Claims and Billing Information
  • Physician Affiliation Agreement and Credentialing
  • Physician Appeals Policy / Form / Quick Reference
  • Physician Advertising
  • Provider Additions and Terminations
  • Provider Newsletters
  • Physician Office Visit Information Form
  • VitalCare Program Materials
• Referrals / UM / Medical Management 
  • Physician Referral Procedures
  • Pre-authorization / Authorization of Services
  • Hospitalization Procedures
  • Utilization Management Plan
  • Technology Assessment Program
    1. SWHP S&W System Providers Technical Assessment Form
    2. SWHP Non-S&W System Providers Technical Assessment Form
• Pharmacy Services
  • Contact the Pharmacy
  • Pharmacy FAQs
  • SWHP Pharmacy List
  • Medicare Part D FWA Training
• Formularies
  • Formulary - Alphabetical
  • Formulary - Specialty
  • Formulary - Texas Rx - 3 tier
  • Formulary - Texas Rx - 4 tier
  • Formulary - SeniorCare Rx
  • P&T Updates
• Forms
  • Authorization form - General/Medical/Surgical
  • Authorization Form - Mental/Behavioral Health
  • Designation as Secondary Care Physician for a Health Plan Patient
  • Eligibility Statement Request Form
  • Eligibility/Benefits/Claim Status Request Form
  • Formulary Addition Request Form
  • Medicare Part D Coverage Determination Request Form
  • Medications Requiring Prior Authorization Request Form
  • MyPlan Web Provider Module Sign On Request Form
  • Practitioner/Provider Appeal Request Form
  • Provider Data Sheet
  • Provider Data Update Form
  • Provider Status Change Form
  • Specialty Drug Request Form
  • Texas Standardized Credentialing Application
• AIM Radiology QI Program
  • Provider Portal
  • Program Description
  • RQI Clinical Guidelines
  • AIM Portal-Cardiac Results Capture Process
  • Training Tools
  • FAQs
  • RQI CPT Codes - 2010
  • RQI Expanded Cardiac Services FAQs
  • Physician's Guide
  • Web User Tips
• How to Become a SWHP Provider
  • Instruction Sheet
  • SWHP Guidelines for Selection
  • Provider Data Sheet
  • Provider Agreement & Credentialing
  • Credentialing / Recredentialing
• VitalCare Program Materials

News and Updates

Provider Orientation/Education Checklist

Provider Directory - Adds/Deletions

Radiology & Lab Ancillary Services

Claims / Billing

DME / Supplies Policy

Physician Appeals Policy / Form / Quick Reference

Quality Improvement Program
Clinical Guidelines

Member Identification Card

Medical Coverage Policies