• Communications

• BlueCard

• National Provider Identifier (NPI)

• NaviNet

• Private Fee-For-Service

• Plan Finder

• Policies & Guidelines

• Claims and Billing Information

• Forms

• Resources for Patient Management

• Quality Management

• Prescription Drug Formulary & Prior Authorization

• IVR (Interactive Voice Response)

• Provider FAQ's

• Contact Information

Private Fee-For-Service

As a provider, you can access a PFFS plan finder, terms and conditions, and payment and reimbursement information. Select Advantage Terms and Conditions Payment Methodology Information Reimbursement Grid Plan Finder To view Terms and Conditions for out-of-area beneficiary’s home plan, go to the Plan Finder. Forms Notice of Medicare Non-coverage (NOMNC) form Detailed Explanation of Non-coverage (DENC) form Notice of Discharge and Medicare Appeal Rights (NODMAR) form Provider Appeals form