Provider Manual

Effective January 1, 2011, Passport Advantage members are required to select a primary care provider (PCP). Members may change PCPs at any time by calling Member Services at 1-800-578-0603, then press 1. (TTY: 1-800-648-6056). Members may not select non-participating providers as PCPs. Please refer to the Provider Alert dated December 17, 2010 for details. The Passport Advantage Provider Manual will be updated in the future to reflect these changes.

• 837 Companion Guides

• Full Provider Manual (PDF)
  Updated March 2011
  Individual Provider Manual Sections:
  • Table of Contents (PDF)
  • Section 1: Introduction (PDF)
  • Section 2: Administrative Procedures (PDF)
  • Section 3: Provider Roles and Responsibilities (PDF)
  • Section 4: Office Standards (PDF)
  • Section 5: Utilization Management (PDF)
  • Section 6: Quality Improvement (PDF)
  • Section 7: Emergency Care Services (PDF)
  • Section 8: Additional Benefits and Programs (PDF)
  • Section 9: Outpatient Pharmacy Services (PDF)
  • Section 10: Clinical Practice Guidelines (PDF)
  • Section 11: Claim Filing Instructions (PDF)
  • Section 12: Important Contact Information (PDF)
  • Section 13: Forms and Documents (PDF)
  • Section 14: Acronyms (PDF)
  • Section 15: Index (PDF)