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Resources and tools for providers and health care professionals

We invite you to use this website, created especially for health care professionals, to find resources that can help you as you care for your patients. Here you can find our medical policies, stay up to date on the latest news or get training on our many tools and benefit plans.

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Our digital solutions offer you the fastest way to find plan information, manage tasks, check statuses and decisions — all without calling.

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News

Maryland Medicaid: Prepare for medical record and billing audit

Use our tips to ensure your documentation is complete, accurate and aligned with billing to avoid denials or recoupments.

Access the current Preferred Lab Network providers

View the current Preferred Lab Network providers.

National Gold Card list updates

As of May 1, 2026, the national Gold Card list has been updated to remove certain codes from prior authorization.

Ohio Medicaid: Prior auth requirements for incontinence and respiratory supplies

View the prior auth requirements for incontinence and respiratory supplies when a non-preferred vendor is utilized.

Ohio Medicaid: Change to doula coordination of benefits

Starting July 1, 2026, you need to bill primary insurance before Medicaid for doula services.

Annual federal audit of commercial plans

You may be randomly selected to provide documentation for the annual HHS-RADV audit program.

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