MAP and MAP BASIC Provider Handbook

Introduction

• Contact Information
• Disclaimer
• MAP & MAP BASIC Contracted Provider Concerns/Inquiries Form

CommUnityCare – Women’s Health Center

• Genetic Counseling
• Gyn Procedures – LEEPs & Colpos
• Gynecology Clinic
• Obstetrics Clinic
• Ultrasounds — Level II

Contracted Providers

• Credentialing
• Dental Services
• Diabetic Retinal Screening
• Durable Medical Equipment
• Home Health Services
• Home Infusion Therapy
• Orthotics and Prosthetics
• Primary Care
• Radiation Oncology
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Coverage and Benefits

• Claims
• Copayments, Groups and Plans
• How to read a MAP/MAP BASIC identification card
• Provider Coverage Verification Instructions
• Provider Practice Discharge Notification Process

Health Services and Authorizations

• Case Management
• Community Care Collaborative Clinical Protocols
• Prior Authorizations

MAP & MAP BASIC Member Information

• Applying for or Renewing MAP and MAP BASIC Coverage
• MAP and MAP BASIC Member Handbooks
• Member Customer Service, Lost Card, and Changing PCP

Pharmacy Services

• MAP & MAP BASIC Formulary
• MAP & MAP BASIC Network Pharmacies
• MAP & MAP BASIC Pharmacy Help Desk
• Non-Formulary Medication Request
• Pharmacy Copayments
• Request for Addition to MAP & MAP BASIC Formulary
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Specialty Care

• Asthma Clinic
• Breast Surgery Clinic
• Cardiology Clinic
• Dermatology Clinic
• Endocrinology Clinic
• ENT Clinic (Head and Neck Surgery)
• Eye (Ophthalmology) Clinic
• Foot Clinic
• Forms
• Gastroenterology Clinic
• General Surgery
• Gynecology/Oncology Clinic
• Hematology
• Neurology Clinic
• Neurosurgery
• Oncology Clinic
• Orthopedic Clinic
• Podiatry Clinic
• Pulmonary Clinic
• Renal/Hypertension Clinic
• Rheumatology Clinic
• Seton Health Plan Coverage Guidelines for Varicose Vein Referral
• Seton Imaging and Radiology — Required Labs
• Surgical Oncology
• Urology Clinic
• Urology Oncology
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