Member Materials

Claim Adjustment Form

McLaren Health Plan and McLaren Health Advantage Provider Claim Adjustments guidelines and form

Drug Formulary – Medicaid

Medicaid Drug Formulary

Medicaid Unique BIN_PCN Payer Sheet

MedWatch Form

Pharmaceutical Management Medicaid

Medicaid pharmaceutical management policies

Preferred Diabetic Test Strips – McLaren Health Plan-Abbott Freestyle

Preferred Diabetic Test Strips-McLaren Health Plan-Abbott Freestyle

Preferred Diabetic Test Strips – McLaren Health Plan-Abbott Freestyle

Preferred Diabetic Test Strips-McLaren Health Plan-Abbott Freestyle

Prior Authorization to Pharmacy Prior Authorization Form

Prior authorization request form

Provider Administrative Appeals

Quick Formulary Guide – Medicaid

Medicaid Quick Guide

Health Risk Assessment – Healthy Michigan Plan

Healthy Behavior Support – Healthy Michigan Plan

Preventive Services Coverage Guidelines - Healthy Michigan Plan

Vision Eligibility Request Form

Copay Information – Healthy Michigan Plan

Healthy Michigan Plan Preventive Services Coverage Guidelines

Healthy Behaviors Incentive Program Provider Education

Provider Guide to Completing Healthy Michigan Plan HRAs

Cultural and Linguistically Appropriate Services (CLAS) Training

Cultural and Linguistically Appropriate Services (CLAS) Training

HEDIS Provider Manual

Hospital Readmissions

Definition of Medical Specialties

List of the Definition of Medical Specialties

Cervical Cancer Screening Incentive

Cervical Cancer Screening Incentive

Diabetic Core Measures Incentive

Diabetic Core Measures Incentive

Healthy Child Immunization Incentive

Healthy Child Immunization Incentive

Timeliness of OB Care Incentive

Billing For Physician Administered Drugs and NDC Reporting

Claims Status Fax Form

Provider Claims Status Fax Form

In-Office Laboratory Billable Procedures

In-Office Laboratory Billable Procedures codes and descriptions

Notification of Pregnancy

Notification Of Pregnancy form

Reference Lab Billing Requirements

2 Question Depression Screen

2023 Provider Incentive

Authorization For Use And Disclosure of Protected Health Information

Authorization For Use And Disclosure of Protected Health Information form

Authorized Representative Form

Chlamydia Screening Incentive

Chronic Care Improvement Program

McLaren Health Plan Joins The Million Hearts Campaign flyer

Club 101 Incentive

Facility Office Standards

Guidelines for contracted practitioner facility standards

Genetic Testing Pre-authorization Requirements

Genetic Testing Pre-authorization Requirements memo

Health Risk Assessment (HRA) Incentive

Healthy Child Developmental Incentive

HEDIS Measures

HEDIS Measures quality indicators sheet

Is This Patient Clinically Depressed?

Clinical depression study and article

Lead Testing Incentive

Mammogram Screening Incentive

Managing Depression In Medical Outpatients

Review article on clinical depression

Medical Record Standards

National Standards For Culturally And Linguistically Appropriate Services In Health Care

National Standards For Culturally And Linguistically Appropriate Services In Health Care executive summary

Recommendations and Rationale - Screening For Depressions

USPSTF statement on depression screening

Referral To Case Management

Referral To Case Management form

SDoH Provider Information

Service Codes Requiring Pre-Authorization

Smoking Cessation Incentive

Specialty Care Medication Site of Care Injectable/Infusible Updated Drug List

UC vs ER Poster

W-9 Request For Taxpayer Identification Number And Certification

W-9 Request For Taxpayer Identification Number And Certification form

Women's Health

Important Tips for Women's Health

McLaren Health Advantage Out-of-Network Provider Payment Methodology

McLaren Health Plan Community Out-of-Network Provider Payment Methodology

Non-Opioid Directive Form

Progeny Health Partnership