Forms & publications
Notice: If you are looking for Apple Health (Medicaid) client forms and publications, please visit our Free or low-cost forms library.
Appendix D - Casualty claims and health insurance claims
General description of casualty and health insurance claims.
Appendix D from behavioral health data guide v5.7
Appendix E - Benefit services packages
Definitions of the different eligibility programs that are offered through Medicaid.
Appendix F - Instructions to fill out the General Information for Authorization Request form
Instructions on how to complete the General Information for Authorization Request form.
Appendix G - How to check status of an authorization
Directions on how to check status of authorization requests through ProviderOne and the interactive voice response system.
Appendix H - Cover sheets for backup documentation
Describes what types of cover sheets are available and when to use them to submit additional information.
Appendix I - Taxonomy and ProviderOne
This document will provide you with a definition of what a taxonomy is and how to verify it is attached to your provider file and allowed for the service being billed.
Appendix J - Medicare crossover claim payment methodology
A description of how Medicaid will pay your crossover claims.
Appendix K - Use the IVR to check claim status
A tool for using the Medical Assistance Customer Service Center's interactive voice system to check claim status.