Provider Relations Team

• Provider Relations Advocate team contact
• Provider Relations Advocate description

Training

• Surest Health Plan (formerly Bind)
• Dual Special Needs Plans Orientation 

Announcements

Member Eligibility

• Third Party Administrator, Affiliates, and Specialty Networks Information

Provider Resources

• Claim Denial Code YV9 Assistance 
• Individual Clinician Recredentialing FAQ
• Initial Credentialing for Individual Clinicians FAQ

Authorization Requirements

Nebraska authorization requirements

Authorization Forms

• Psych and Neuropsych Testing Authorization Request form
• TMS & ECT Authorization Request form

General Information

• Immediate follow-up appointments available
• Information and resources for working with Medica Behavioral Health

Psychological Testing Request Forms

• Medica Psych Testing Request Form - (PDF download)

Other Authorization Request Forms

• Medica Medicare Behavioral Health Quick Reference Guide
  
• Mental Health Retrospective Request Form - Medica Behavioral Health - MN CAC

UnitedHealthcare Community Plan of Nebraska 

• Prior Authorization Code List 
• Peer Support Services -  Billing CPT Code H0038
• Peer Support Services - Goals and Treatment Guide
• Medicaid-Medicare DSNP Billing Guidance

Orientation and Trainings

• Coming soon

Clinical Criteria Guidelines

• Guidelines

Medicaid Quick Reference Guides

• Retro eligibility

Medicaid Authorization Information

• Certification for need for services
• Crisis stabilzation admission notification
• GT Modifier Alert 
• LAI buy and bill authorization request
• Medicaid ABA treatment request form
• Medicaid critical incident report
• MRO authorization request
• Medicaid rehabilitation option and peer support services, treatment review and authorzation request
• Community health service request form
• Community-based outpatient prior authorization training
• Nebraska prior authorization FAQs
• Prior authorization requirements for UnitedHealthcare Community Plan of Nebraska