• Medication Prior Authorization Request Form
• Breast Cancer Screening Exclusion Form
• Cervical Cancer Screening Exclusion Form
• Continued Outpatient Treatment Notification Form
• Michigan Tobacco Quitline Referral Form
• Healthy Living Diabetic Supply Form
• Referral and Authorization Request Form
• Authorization Overview - 2010
  
• CAQH Credentialing Application
  
• Diabetic Foot Exam for $5 Reimbursement
  
• MAHP Credentialing Application
  
• PCP Overview of HEDIS 2010 Bonus Program
  
• HEDIS Bonus Table 2010
  
• HEDIS Criteria 2010
• OB Bonus Program 2010
  
• Informed Consent to Sterilization
  
• Lead Testing Guideline
• Lead Testing Criterion
  

Clinical Practice Guidelines 2010

All Clinical Practice Guidelines are available in hard-copy upon request.  Please contact the Provider Service Department at 1-888-773-2647 to request hard copies.

Clinical Practice Guidelines