Provider Resources
General Resources and Guides
- HIPAA X 12 Transaction Standards – Companion Guide (PDF)
- Claim Appeal Form (PDF)
- Request for Claim Status Form (PDF)
- PaySpan Registration (PDF)
Providers in Arizona
- Arizona Provider Manual (PDF)
- Arizona Billing Reference (PDF)
- Hospital/Ancillary Provider Credentialing Application (PDF)
- Physician Credentialing Application (PDF)
- Disclosure of Ownership Form (PDF)
Providers in Delaware
- Delaware Provider Manual (PDF)
- Delaware Billing Reference (PDF)
- Hospital/Ancillary Provider Credentialing Application (PDF)
- Physician Credentialing Application (PDF)
- Disclosure of Ownership Form (PDF)
Providers in Florida
- Florida Provider Manual (PDF)
- Florida Billing Reference (PDF)
- Hospital/Ancillary Provider Credentialing Application (PDF)
- Physician Credentialing Application (PDF)
- Disclosure of Ownership Form (PDF)
Providers in Idaho
- Idaho Provider Manual (PDF)
- Idaho Billing Reference (PDF)
- Hospital/Ancillary Provider Credentialing Application (PDF)
- Physician Credentialing Application (PDF)
- Disclosure of Ownership Form (PDF)
Providers in Indiana
- Indiana Provider Manual (PDF)
- Indiana Billing Reference (PDF)
- Hospital/Ancillary Provider Credentialing Application (PDF)
- Physician Credentialing Application (PDF)
- Disclosure of Ownership Form (PDF)
Providers in Kansas
- Kansas Provider Manual (PDF)
- Kansas Billing Reference (PDF)
- Hospital/Ancillary Provider Credentialing Application (PDF)
- Physician Credentialing Application (PDF)
- Disclosure of Ownership Form (PDF)
Providers in Minnesota
- Minnesota Provider Manual (PDF)
- Minnesota Billing Reference (PDF)
- Minnesota Statute – Inmate Inpatient Eligibility (PDF)
- Hospital/Ancillary Provider Credentialing Application (PDF)
- Physician Credentialing Application (PDF)
- Disclosure of Ownership Form (PDF)
Providers in Missouri
- Missouri Provider Manual (PDF)
- Missouri Billing Reference (PDF)
- Hospital/Ancillary Provider Credentialing Application (PDF)
- Physician Credentialing Application (PDF)
- Disclosure of Ownership Form (PDF)