Medicaid Provider Manual: Virginia Premier Health Plan, Inc.

Medicaid Provider Manual

Medicaid Provider Manual

Exhibit A - OB Registration Form

Exhibit B - Certificate of Medical Necessity

Exhibit C - PA Request Form

Exhibit D - IOTR Form _edit 09.03.08

Exhibit E - OTR Form

Exhibit F - Request for Psychological Testing

Exhibit G - QI Program Description 2010

Exhibit H - Utilization Management Program Description 2010

Exhibit I - Credentialing Program Description 2010

Exhibit J - Practioner Golden Globe Award

Exhibit K - Question to Ask Your Doctor

Exhibit L - 20 Tips to Prevent Medical Errors

Exhibit M - Bereavement Program

Exhibit N - Summary of VA Healthcare Decisions Act

Exhibit O - Clinical Practice Guidelines

Exhibit P - Authorization Form - HEPATITIS

Exhibit Q - Authorization Form - GROWTH HORMONE

Exhibit R - Authorization Form - RHEUMATOLOGY

Exhibit S - Authorization Form - DERMATOLOGY

Exhibit T - Authorization Form - MULTIPLE SCLEROSIS

Exhibit U - Authorization Form - GENERIC Rx & STOCK REPLACEMENT

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