Provider materials and forms 

• Provider manual (PDF)
  
• Quick reference guide (PDF)
  
• Formulary guide (PDF)
• ER Sudden & Serious Auto Pay List (PDF)
• Authorization for Representative (PDF)

Shared decision-making aids are communication tools that both providers and patients can use to make informed health care decisions based on the patients’ needs. These tools do not replace physician guidance but are intended to help complement the discussions between patients and physicians on treatment decisions.
 

You can see these evidence-based aids that provide information about treatment options, lifestyle changes and outcomes.

• American Heart Association: Health topics
• American Heart Association: Diabetes
• American Heart Association: Flu prevention
• American Heart Association: Heart facts - treatments and tests
• Mayo Clinic: Care that fits
• Mayo Clinic: Statin choice decision aid
• Mayo Clinic: Care that fits - depression medication choice
• Mayo Clinic: Care that fits - cardiovascular primary prevention choice
  

• Standard PA request form (PDF)
• Pharmacy PA request forms

• Appeal form (PDF)
• Provider Dispute and Resubmission Form (PDF)

• Maryland Prenatal Risk Assessment Form (PDF)
• Local health services request form
• HealthChoice Diabetes Prevention Program referral form (PDF)
  
• Care Management Referral Form (PDF)

• CMS 1500 (PDF)
• UB-04 (PDF)