Medical Access Program Provider Handbook

Introduction

• Introduction
• MAP Contact Information

MAP BASIC

• MAP BASIC Provider FAQ
• MAP BASIC Member Benefits
• People's MAP BASIC Pharmacy List
• CommUnityCare MAP BASIC Pharmacy List

Coverage and Benefits

• Claims
• Copayments, Groups and Plans
• How to read a MAP/MAP BASIC identification card
• Provider Coverage Verification Instructions

Health Services and Authorizations

• Community Care Collaborative Clinical Protocols
• Case Management
• Prior Authorizations
• Seton Health Plan Coverage Guidelines for Varicose Vein Referral

MAP Member Customer Service

• Medical Access Program Request Form for Change of Patient’s Primary Care Office
• Compliments and Complaints
• MAP RENEWAL and/or EXPIRED COVERAGE
• Customer Service Phone Lines
• Eligibility Offices
• Lost MAP ID Cards
• Change of Address
• Provider Practice Discharge Notification Process
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Contracted Providers

• Dental Services
• Diabetic Retinal Screening
• Durable Medical Equipment
• Home Health Services
• Home Infusion Therapy
• Orthotics and Prosthetics
• Primary Care
• Radiation Oncology
• Urgent/Convenient Care
• Credentialing
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Pharmacy Services

• MAP & MAP BASIC Formulary
• Network Pharmacies
• MAP & MAP BASIC Pharmacy Help Desk
• Non-Formulary Medication Request
• Pharmacy Copayments

Specialty Care

• Asthma Clinic
• Breast Surgery Clinic
• Cardiology Clinic
• Dermatology Clinic
• Endocrinology Clinic
• ENT Clinic (Head and Neck Surgery)
• Eye (Ophthalmology) Clinic
• Foot Clinic
• Forms
• Gastroenterology Clinic
• Gynecology/Oncology Clinic
• Hematology
• Neurology Clinic
• Oncology Clinic
• Orthopedic Clinic
• Pulmonary Clinic
• Renal/Hypertension Clinic
• Rheumatology Clinic
• Seton Imaging and Radiology — Required Labs
• General Surgery
• Urology Clinic
• Neurosurgery
• Surgical Oncology
• Podiatry Clinic
• Urology Oncology
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CommUnityCare – Women’s Health Center

• Genetic Counseling
• Gyn Procedures – LEEPs & Colpos
• Gynecology Clinic
• Obstetrics Clinic
• Ultrasounds — Level II