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Handbook Table of Contents
» Management and Administration
Handbook Table of Contents
Introduction Letter
Welcome
Provider Information
Eligibility
Program Options
Medical Coverage
Behavioral Health
Management & Administration
Claims Processing
Reimbursement Methodologies
FAQs
Glossary
List of Tables
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Health Care Management and Administration
This section outlines:
Referrals
Prior Authorizations
Providing Care to Beneficiaries from Other Regions
Medical Records Documentation
Utilization Management
Quality Management
Fraud and Abuse
Grievances
Appeals
Related Links
Acronym List
Provider Forms
Uniform Bill Form Sample (UB-04) with instructions
Health Insurance Claim Form Sample (CMS-1500) with instructions
Last Update: January 15, 2011