Provider Self-Service Tools
The information you need is available to you online, 24/7. Our Provider self-service tools help you get the most out of partnering with us.
COVID-19
Stay informed. Get the latest information on COVID-19.
- Clinical Practice Guidelines
- Consumer Assessment of Healthcare Providers and Systems (CAHPS)Consumer Assessment of Healthcare Providers and Systems (CAHPS)
- Cultural Competency
- Educational WebinarsEducational Webinars
- HEDIS GuidelinesHEDIS Guidelines
- Adults’ Access to Preventive/ Ambulatory Health Services (AAP)
- Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB)
- Breast Cancer Screening (BCS)
- Colorectal Cancer Screening (COL)
- Diabetes Care
- Follow-Up Care for Children Prescribed ADHD Medication (ADD)
- HEDIS Measure Guidelines for Behavioral Health Providers HEDIS Measure Guidelines for Behavioral Health Providers
- Follow-Up Care for Children Prescribed ADHD Medication (ADD)
- Antidepressant Medication Management (AMM)
- Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)
- Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)
- Follow-Up After Emergency Department Visit for Substance Use (FUA)
- Follow-Up After Hospitalization for Mental Illness (FUH)
- Follow-Up After High-Intensity Care for Substance Use Disorder (FUI)
- Follow-Up After Emergency Department Visit for Mental Illness (FUM)
- Initiation and Engagement of Substance Use Disorder Dependence Treatment (IET)
- Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA)
- Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)
- HEDIS Measurement Year (MY) 2022 Provider Tips for Optimizing HEDIS Results HEDIS Measurement Year (MY) 2022 Provider Tips for Optimizing HEDIS Results
- Best Practices Overall for Coding
- Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)
- Adults’ Access to Preventive/Ambulatory Health Services (AAP)
- Advanced Care Planning (ACP)
- Antibiotic Utilization for Respiratory Conditions (AXR)
- Antidepressant Medication Management (AMM)
- Appropriate Testing for Children with Pharyngitis (CWP)
- Appropriate Treatment for Upper Respiratory Infection (URI)
- Asthma Medication Ratio (AMR)
- Avoidance of Antibiotic Treatment for Acute Bronchitis/ Bronchiolitis (AAB)
- Blood Pressure Control for Patients With Diabetes (BPD)
- Breast Cancer Screening (BCS)
- Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC)
- Care for Older Adults (COA)
- Cervical Cancer Screening (CCS)
- Child and Adolescent Well-Care Visits (WCV)
- Childhood Immunization Status (CIS)
- Chlamydia Screening in Women (CHL)
- Colorectal Cancer Screening (COL)
- Controlling High Blood Pressure (CBP)
- Deprescribing of Benzodiazepines in Older Adults (DBO)
- Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD)
- Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)
- Eye Exam for Patients With Diabetes (EED)
- Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA)
- Follow-Up After Emergency Department Visit for Mental Illness (FUM)
- Follow-Up After High- Intensity Care for Substance Use Disorder (FUI)
- Follow-Up After Hospitalization for Mental Illness (FUH)
- Follow-Up Care for Children Prescribed ADHD Medication (ADD)
- Hemoglobin A1c Control for Patients With Diabetes (HBD)
- Immunizations for Adolescents (IMA)
- Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET)
- Kidney Health Evaluation for Patients with Diabetes (KED)
- Lead Screening in Children (LSC)
- Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)
- Osteoporosis Management in Women Who Had a Fracture (OMW)
- Osteoporosis Screening in Older Women (OSW)
- Persistence of Beta- Blocker Treatment After a Heart Attack (PBH)
- Pharmacotherapy Management of COPD Exacerbation (PCE)
- Prenatal and Postpartum Care (PPC)
- Risk of Continued Opioid Use (COU)
- Statin Therapy for Patients with Cardiovascular Disease (SPC)
- Statin Therapy for Patients with Diabetes (SPD)
- Transitions of Care (TRC)
- Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)
- Use of Imaging Studies for Low Back Pain (LBP)
- Use of Opioids at High Dosage (HDO)
- Use of Opioids from Multiple Providers (UOP)
- Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)
- Well-Child Visits in the First 30 Months of Life (W30)
- Lead Screening in Children (LSC)
- Pediatrics/Adolescents Management
- Pharmacotherapy Management of COPD Exacerbation (PCE)
- Use of Imaging Studies for Low Back Pain (LBP)
- HealthSphereHealthSphere
- HorizonDocs
- Manuals & User GuidesManuals & User Guides
- Agreements
- Ancillary Manual Ancillary Manual
- The BlueCard® Program
- Claims Submissions and Reimbursement
- Coordination of Benefits
- HIPAA
- Horizon Behavioral Health
- Horizon Hospital Network
- Identification
- Inquiries, Complaints and Appeals
- Member Rights and Responsibilities
- Patient-Centered Programs
- Patient Health Support
- Policies, Procedures and General Guidelines
- Products
- Provider Responsibilities
- Quality Management
- Referrals
- Service
- Utilization Management
- Hospital Manual Hospital Manual
- Claims Submission and Reimbursement
- Coordination of Benefits
- HIPAA
- Horizon Behavioral Health
- Identification
- Inquiries, Complaints and Appeals
- Member Rights and Responsibilities
- Patient Health Support
- Patient-Centered Programs
- Policies, Procedures and General Guidelines
- Products
- Programs Administered by eviCore healthcare
- Provider Responsibilities
- Quality Management
- Quality Recognition Programs
- Service
- The BlueCard Program
- Utilization Management
- Participating Physician and Other Health Care Professional Office Manual Participating Physician and Other Health Care Professional Office Manual
- At Your Service
- The BlueCard Program
- Claims Submissions and Reimbursement
- Coordination of Benefits
- HIPAA
- Horizon Behavioral Health
- Horizon Hospital Network
- Identification
- Inquiries, Complaints and Appeals
- Member Rights and Responsibilities
- Patient-Centered Programs
- Patient Health Support
- Payment Summaries and Vouchers
- Policies, Procedures and General Guidelines
- Products
- Provider Responsibilities
- Quality Management
- Quality Recognition Programs
- Referrals
- Service
- Special Programs
- Utilization Management
- Welcome Kit
- Network SpecialistsNetwork Specialists
- Provider Self-Service ToolsProvider Self-Service Tools
- Drug Authorizations Tool
- Eligibility and Benefits Cost Share Estimator
- NaviNet
- Prior Authorization Procedure Search Tool
- Provider Data Maintenance Tool
- Utilization Management Request Tool
- Videos
- Provider communications resources
- Quality Resource CenterQuality Resource Center
- Educational Materials Educational Materials
- Achieving Success in Quality Improvement
- Quality Management 2021 Webinars Quality Management 2021 Webinars
- Overview
- Adult Measures
- Pediatric Measures
- ADHD
- Asthma
- Achieving Quality Compliance
- Resources
- What’s the Code?
- Lead
- Clinical Documentation Improvement
- Telehealth
- Optimizing Monthly Results and Recognition Quality Reports
- Horizon Docs
- Risk Adjustment
- What’s the Code?
- Colorectal Cancer Screening
- Results & Recognition Program Results & Recognition Program
- TrainingTraining
COVID-19
Stay informed.
Get the latest information on COVID-19.
Get the latest information on COVID-19.