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For Providers

Welcome to the portion of the HealthPlus Web site designed specifically for you — our valued provider!

NPI News
Below are some useful links to resources regarding new NPI requirements:
NPI Implementation for HealthPlus
Information on the CMS 1500
National Uniform Billing Committee UB-04
Where to obtain a NPI
Frequently Asked NPI Questions

This section provides access to the Provider Online Service Center, which allows HealthPlus network providers to view their personal HealthPlus enrollee lists and eligibility information, access referral and claims details, send an e-mail to HealthPlus and search for other health care providers online!

This section also provides immediate access to clinical practice guidelines, online versions of the HealthPlus drug formularies, online provider directories, and more! To find the information you need, click the appropriate link below.

Provider Online Service Center

If you have already registered for the Provider Online Service Center, click here to log in.

If you have not yet registered for the secure Provider Online Service Center and would like to take advantage of its available services, completion and submission of the Provider Portal Access Request Form is required. Click here for a printer-friendly version of the form (submission instructions included on form) OR contact your HealthPlus Provider Services Representative to assist you with registration.

 

Physician Resources

New Provider Chronic Disease and Health and Wellness Resources and Tools
You may directly access information for each of the topics included in the toolkit through the links below:

2007 - 2008 Flu Season
HealthQuest Diabetes Management Program
Cardiac Disease Management Program
Impact Conditions Management
Clinical Practice Guidelines
Quality Improvement Program Description
NewOrientation for WEB Referrals (PDF)

HealthPlus of Michigan Imaging Management Program

Imaging Management Program Contact Information
Process to Prior Authorization High Tech Radiology Services
HealthPlus of Michigan Prior Authorization List
Generic Prior Authorization Form
Generic CT/CTA Prior Authorization Form
Spine CT Prior Authorization Form
Generic MR/MRA Prior Authorization Form
Spine MRI Prior Authorization Form
PET Prior Authorization Form
Imaging Management Program CPT Code Change-Out Form
HealthPlus of Michigan Privileging by Specialty
Facility Assessment Tool - Free Standing Radiology Facility
Facility Assessment Tool - In Office Physician Imaging
Non ARRT Application
Imaging Management Program - Update 10 01 2007


Click for Care Core National Web site

Pharmacy

Ask for 90Effective Aug. 8, 2006, members with a prescription drug benefit that includes mail order in HealthPlus, HealthPlus Options, and HealthPlus Senior (Medicare) are eligible for our exciting Ask for 90 Rx Program at local retail pharmacies! Click for FAQ's (PDF file*)
Click for a list of participating pharmacies (PDF file*)
Click for Color Poster(PDF file*)
Click for BW Poster (PDF file*)

Drug Formularies, All HealthPlus Product Lines
Epocrates software download for PDA
Pharmacy Prior Authorization Form
HealthPlus Partners Over-the-counter Medication Summary

Medical Case Management

About our Medical Case Management Program
Case Management Referral Form

More Useful Links

Appeals Process
Claims Adjustment Form Submission
Claims Submission Guidelines
Claims Adjustment Form
Click here for FREE Epocrates software ...free PDA downloads for all HealthPlus
Formularies!

2007 FAX Product Order Form
Grievance Process
Member Discharge/Termination Request Form
Member Rights and Responsibilities
Member Satisfaction Plan
Medical Prior Authorization
Medical Record Forms
Patient Safety
Physician Materials
Provider Directories
Provider Records Change Form w/directions


Preventive Health Guidelines




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Updated 11/19/07