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2025-2026 Anti-Fraud Plan
2025 FWA Audit Plan - Supplemental Guide
Centers for Medicare and Medicaid Services - Fraud and Abuse
Clinical Practice Guidelines
Create Your Highmark Health Options NaviNet Account
Cultural Competency Data Form
EPSDT Member Outreach Form
Fraud and Abuse Laws and Regulations
Gold Card Program FAQs
GuidingCare User Guide
HealthHelp: Single Sign-On Capabilities
Member Outreach Form
NaviNet and Provider Portal Training Guide
Notice of Practice/Practitioner Changes Form
Obstetrical Needs Assessment Form (ONAF)
Outpatient Behavioral Health Prior Authorization Request Form
Outpatient Therapy Services Prior Authorization Request Form
PCP Transfer Form
PNC Echo UI Users Guide
Private Duty Nursing (PDN) Prior Authorization Request Form
Provider Appeals Submission Form
Provider Complaint Forms
Provider Roster Worksheet (xlsx)
Provider Self-Audit Information
Provider Self-Audits Overpayments Form – Medicaid
Quality of Care/Quality of Service Concern External Reporting Form
Referral Request for Maternal Opioid Use Disorder (MOUD) Treatment
Request for Medicaid Drug Exception Form
SSBCI Attestation Form
Substance Abuse Prior Authorization Request Form
SUD 48-Hour Notification of Admission (ASAM) Form
Provider Self-Audits Overpayments Form – D-SNP
Language Identification and Interpretation Request Poster
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