For Select Health Network Providers:

PROVIDERS:
IMPORTANT NOTICE REGARDING CLAIMS ADMINISTRATION & UTILIZATION MANAGEMENT EFFECTIVE 9/19/2011
read the notice

CMCS Web Portal

Click here to connect to the CMCS web portal, where you can check claims and authorization status.


Provider Downloads (password required)

• Alphabetical Provider List
• Ancillary Providers
• Specialty List
• Pre Certification List
• Biotech Injectable List
• Prior Authorization Form
• Provider Change Notification
• Provider LOA Notification
• Provider Newsletter
• Provider Termination Notification
• Utilization Management Guidelines

Login to access these downloads now. If you are a SELECT Health Network Provider and do not have a password, please contact us at 574-283-5959.


MDwise Information

MDwise web site: www.mdwise.org

MDwise Provider Forms:

• Pre-Birth Selection Form - download now
• Prior Authorization Form - download now
• MDwise Reassignment Form - download now
• New Member Intervention & Education Form - download now

MDwise Behavioral Health: Outpatient Treatment Request Form (OTR) - Download Now (pdf format, posted Nov 2011)