Provider Forms and Resources
PROVIDER FORMS AND RESOURCES
Behavioral Health Coordination of Care
- Provider Toolkit
- Oklahoma Standard Authorization to Use or Share Protected Health information
- Mental Health, Chemical Dependency & Substance Abuse Coordination of Care Screening and Referral Form Instructions
- Mental Health, Chemical Dependency & Substance Abuse Coordination of Care Screening and Referral Form
Claims
- GlobalHealth Commercial Plans Claim Reconsideration Request Form
- Generations Medicare Advantage Plans Reconsideration Request Form
- Certification of Treating Health Care Provider (English) (en Espanol)
- Physician Certification - Experimental or Investigational Denials (English) (en Espanol)
- Waiver of Liability Form
HAX Provider Portal
Important Notices for Providers
- The 2023 Provider Manual is now available.
Important Resources
- Opioid- Related Educational Resources (Free CME)
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The National Committee for Quality Assurance (NCQA) and Boston University School of Medicine have developed two new opioid related CME opportunities that address how to treat opioid misuse disorder in the primary care setting. The CME are provided free of charge.
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GlobalHealth supports safe, effective treatment with various activities, such as provider and member education, Provider Behavioral Health toolkits and behavioral health and substance abuse treatment. GlobalHealth collects and reports annual data on two HEDIS opioid related measures. Our pharmacy team monitors opioid prescriptions for high dosages, multiple fills, multiple providers and/or pharmacies. When these are identified, we work with the provider(s) and member to ensure clear communication and coordination of care.
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While the programs are developed for Primary Care, GlobalHealth encourages all of our network providers to review the information.
- Additional resources:
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- Prescribing Biosimilars
- With the increasingly complex usage of biologic medications and biosimilars it is important to provide provider based education and methods for encouraging the use of biosimilars.
- Additional Resources: Biosimilar Product Regulatory Review and Approval
- Updated Vaccination Information Sheets (VIS)
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The CDC routinely reviews and updates the Vaccine Information Sheets (VIS) that you are required by law to give patients when you give a vaccine. Please check here for current VIS. VIS are also available in many languages at http://www.immunize.org/vis/. The website provides additional resources about immunization for providers, staff and patients.
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- CDC Epidemiology and Prevention of Vaccine-Preventable Diseases ("Pink Book" - 13th ed.)
- The 13th Edition Epidemiology and Prevention of Vaccine-Preventable Diseases, a.k.a. the “Pink Book,” provides physicians, nurses, nurse practitioners, physician assistants, pharmacists, and others with the most comprehensive information on routinely used vaccines and the diseases they prevent. Six appendices contain a wealth of reference materials including: vaccine minimum ages and intervals, current and discontinued vaccines, vaccine contents, foreign vaccine terms, and more. Also available at: https://www.cdc.gov/vaccines/pubs/pinkbook/index.html
Prior Authorization
Provider Policies and Training
Quality
Quality Portal
Transparency in Coverage (Commercial Providers)
What is Transparency in Coverage?
On November 12, 2020, the Departments of Health and Human Services, Labor and the Treasury finalized the Transparency in Coverage Rule that requires health insurers and group health plans to create a member-facing price comparison tool and post publicly available machine-readable files that include in-network negotiated payment rates and historical out - of network charges for covered items and services, including prescriptions drugs. The requirements in this rule will give consumers the tools needed to access pricing information through their health plans.
For more information about the Transparency in Coverage rule, please click here to access CMS final rule.
Transparency in Coverage (Machine Readable files)
Insurers and Plans are required to publish Machine Readable Files and make available to public by 07/01/2022. Data in machine readable files must be updated monthly.
To access GlobalHealth MRF file please click below.