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FAQ
2024 Provider Manual
2023 Provider Manual
2022 Provider Manual
Provider Quick Reference Guide
Provider Information Update Form
EOP and 835 Reference Guide
FQHC/RHC Provider Billing Guide
Reimbursement Policy: DME Rental vs. Purchase—Marketplace
Universal IAMHP Roster Template (Excel Download)
W-9 Form (irs.gov)
Prior Authorization LookUp Tool
Q1 2025 Prior Authorization Codification List
Q4 2024 Prior Authorization Codification List
Q3 2024 Prior Authorization Codification List
Q2 2024 Prior Authorization Codification List
Q1 2024 Prior Authorization Codification List
Q4 2023 Prior Authorization Codification List
Illinois Marketplace Prior Authorization Pre-Service Review Guide & Forms
Illinois Marketplace Prior Authorization Pre-Service Review Guide & Forms (01/01/2025)
Illinois Marketplace Pharmacy Prior Authorization Request Form
Illinois Marketplace MCG Cite AutoAuth Advanced Imaging Training (download to play videos)
Illinois 2023 Marketplace PA Approval/Denial Report
Claims Dispute Request Form
Appeal Consent Form
No Surprises Act - Independent Dispute Resolution Form (Non-Contracted Providers only)