The links below provide access to commonly used forms and other helpful reference materials. Please note that these resources are for professionals currently contracted with Community Health Options®.
If you are not currently contracted with us and would like to be, please contact:
Behavioral health providers: Behavioral Healthcare Program at 800.538.9698.
Billing Information Form - Use this form for practice demographic changes.
Claims Reconsideration Form • Billing Corrected Claims Information Sheet
Electronic Funds Transfer (EFT) Authorization Agreement
Provider Credentialing and Change Form - Use this form for contracted provider adds, changes, and terms.
Notification/Prior Approval Form
Prescription Prior Approval Form
Prior Approval Overview & Notification (effective 6/1/17)
Medical Prior Approval & Notification Requirements - Quick Reference Guide (effective 6/1/17)
Durable Medical Equipment Prior Approval Requirements - Quick Reference Guide (effective 6/1/17)
Behavioral Health Prior Approval & Notification Requirements - Quick Reference Guide (effective 6/1/17)
Medications Prior Approval & Notification Requirements - Quick Reference Guide (effective 6/1/17)
* For web portal access, please contact us at firstname.lastname@example.org.
Rx Savings Solutions - FAQs for Providers
Chronic Illness Support Program
Grace Period Notifications
Health and Wellness Information
HEDIS Measurement Definitions
Quick Reference Guide for Providers
Value Based Insurance Design (VBID) Overview