Provider manuals and guides

• Quick reference guide (PDF)
• Provider manual (PDF)
  • Dental provider supplement (PDF)
  • Discharge planning guide (PDF)
  • Minor rights addendum (PDF)
• Access to care standards
• Medical (PDF)
• Behavioral health (PDF)
• COMPASS Program Guide (PDF)
• Collecting Social Determinants of Health Data to Address Enrollees’ Unmet Needs (PDF)
• Using Z Codes: The Social Determinants of Health (SDOH) (PDF)
• Improving the Collection of Social Determinants of Health (SDOH) Data with Z Codes (PDF)
• Programs at a glance (PDF)

The Healthcare Effectiveness Data and Information Set (HEDIS) is now available on NaviNet. Learn more.

Value-Based Program

We are committed to helping you deliver the best care to your patients. In the effort to meet our providers’ needs and priorities for care delivery, we created the PerformPlus® Total Cost of Care program (PDF) for participating providers. We also developed a document to help you understand your scorecard (PDF).

• PerformPlus® True Care Behavioral Health Program (PDF)
• PerformPlus® True Care — Maternity Care Providers (PDF)
• Dental Value-Based Compensation Program (PDF)