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Providers

Provider Manual

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
  • MyBenefits 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
    1. SWHP S&W System Providers Technical Assessment Form
    2. SWHP Non-S&W System Providers Technical Assessment Form
  • Physician Reports
  • Quality Improvement Program
  • Clinical Guidelines
  • RQI Program Description
  • RQI Provider Portal
  • RQI CPT Codes - 2010
  • RQI Clinical Guidelines
  • Cardiac Results CaptureV4-AIM Portal
  • 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

    • SWHP110