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Questions?
Just call Provider Relations at 1-866-638-1232 (TTY: 711). We’re here for you Monday through Friday, 8 AM to 5 PM.
Getting started
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Getting started
When you join our network, we’ll provide an initial orientation. After that, you’ll have ongoing training and education, including webinars, periodic provider newsletters and bulletins, and so much more.
Questions about joining our network? Just visit the join our network page for more information.
You can also check the quick reference guide or the provider manual for answers to many of your questions. Or you can call us at 1-866-638-1232 (TTY: 711).
Availity® training
The Provider Portal is an online tool that lets us communicate health care information directly to providers. In 2021, we transitioned from the Medicaid Web Portal (MWP) to Availity as our Provider Portal.
You need to register for the Availity Provider Portal before you can start using its many features. To learn more about how to register for the Availity Provider Portal, just visit the Provider Portal page.
Training and resources
Everyone should have a fair and just opportunity to be as healthy as they can be. Learn more about health equity and the obstacles and solutions to this goal on our health equity page.
Trauma-informed care responds to the impact of trauma through recognition and understanding. We take our members’ safety and ability to make their own choices seriously.
Trauma Informed Care (TIC) An Introduction for providers
Trauma Informed Care
Introduction to Trauma-Informed Care
Trauma-Informed Care in Foster Care
You can find more information about training on the HEDIS page.
Aetna Better Health Kids Provider Webinar
Wednesday October 16, 2024, 11 am EST
Topics we’ll cover:
This month's Aetna Better Health Kids Hot Topic webinar features a discussion on the Disclosure of Ownership & Controlling Interest Worksheet (DOO Form) and other important information.
We'll provide some information on the following topics:
- What is the purpose of the DOO Form?
- How do you completion the DOO Form?
- What are the Access and Availability Guidelines?
- How can you use the Availity Portal to support the day-to-day needs of your office?
Don't miss this important webinar!
Register today! Hope to see you there!
Upcoming webinar dates and tentative topics:
All webinars are held from 11am-12pm EST
- June 26, 2024 — Behavioral Health
- August 21, 2024 — Credentialing
- October 16, 2024 — Hot Topic Webinar & Other Essential Information (PDF)
- December 18, 2024 — Topic To Be Determined
Check back closer to the registration date to RSVP.
Past webinar presentations
June 2024 : Behavioral Health Webinar (PDF)
December 2023: Provider Appeals and Disputes (PDF)
September 2023: Quality Management, Benefits Update (PDF)
June 2023: MANNA, Pharmacy and Benefits Update (PDF)
March 2023: Updates and Changes
August 2022: Medicaid closure and CHIP update
July 2022: PA Medicaid closure process & CHIP team introductions (PDF)
June 2022: CHIP expansion and Medicaid closure (PDF)
May 2022: CHIP expansion and Medicaid closure (PDF)
April 2022: CHIP expansion and Medicaid closure (PDF)
March 2022: Provider benefits and CHIP expansion (PDF)
November/December 2021: Availity tips and cultural competency (PDF)
October 2021: Provider manual and hot topics (PDF)
September 2021: Billing requirements, long-term acute care (LTAC) and vendors (PDF)
August 2021: Prior authorizations (PDF)
July 2021: Special Needs Unit (PDF)
June 2021: Metropolitan Area Neighborhood Nutrition Alliance (MANNA) (PDF)
May 2021: Provider appeals and disputes (PDF)
April 2021: Availity (PDF)
March 2021: Claims and billing tips for successful outcomes (PDF)
February 2021: Credentialing (PDF)
2023 dates coming soon.
Questions about EVV before or after the webinar? Just email us and add “EVV question” in the subject line.
Coming soon
You can find more information on our pharmacy benefits page.
Statewide preferred drug list (PDL) FAQs for providers (PDF)
Asthma medication formulary updates (PDF)
FAQs about provider PROMISe ID enrollment, revalidation and ordering, referring, prescribing (ORP) enrollment processes (PDF)
Instructions for providers to check on the status of their PROMISe ID enrollment (PDF)
837 I/P taxonomy requirement (PDF)
PROMISe ID enrollment claims processing issue identified (PDF)
PROMISe ID enrollment to be required at all service locations (PDF)
Required enrollment of ordering, referring and prescribing providers (CHIP) (PDF)
Required enrollment of ordering, referring and prescribing providers (Medicaid) (PDF)
You can find more information on our complaints, grievances and appeals page.
Changes to complaints, grievances and appeals process (PDF)
Provider appeal form (PDF)
Provider notices and newsletters
Pennsylvania Medicaid closure process guide (PDF)
Telephonic Psychiatric Consultation Service Program (TiPS)
2021 provider pay for quality (P4Q) tip sheet (PDF)
International Accreditors for Continuing Education and Training (IACET)
Accreditation Council for Continuing Medical Education (ACCME)
Case Management Society of America (CMSA)
Substance Abuse and Mental Health Services Administration (SAMHSA)
American Society of Addiction Medicine (ASAM)
Suicide Prevention Resources Center
Agency for Healthcare Research and Quality (AHRQ)
Communication between health care professionals can lead to better outcomes for patients. Not sure where to start? You can check out these FAQs about how to discuss sensitive topics.
When and how can you share info about patients you’re treating for mental health conditions?
What are some ways to address social determinants of health challenges?
Where can you learn more about the HIPAA privacy rule?
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).