Resources

Opioid information from the Centers for Disease Control and Prevention (CDC)

First Choice VIP Care Plus (Medicare-Medicaid Plan) values excellent relationships with our health care providers. Together, we can work to improve the quality of and access to care for our members.

Use this section of our site to access the resources you need most, including:

Behavioral health forms

• Behavioral health outpatient treatment request (PDF)
• Behavioral health clinical fax (PDF)
• Neuropsychological and psychological testing request (PDF)
  
  

Claims and billing

• Appropriate usage of claims modifiers 25 and 59 (PDF)
• Claim dispute form (PDF)
• Common errors for claims processing (PDF)
• Electronic Claims Submission
  Payer ID: 77009
• Paper Claims Submission:

First Choice VIP Care Plus
Claims Processing Department
P.O. Box 7106
London, KY 40742-7106

Credentialing

• Become a patient-centered medical home (PCMH)
• Credentialing

Prior authorization

• Prior authorization

Quality resources

• Adult Body Mass Index (BMI) Assessment Claims Coding Chart (PDF)
• Care for the Older Adults (COA) Claims Coding Chart (PDF)
• Care for Older Adults (COA) Form (PDF)
• Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and Health Outcomes Survey (HOS) Information (PDF)
• Controlling Blood Pressure Claims Coding Chart (PDF)
• Diabetes Treatment (PDF)
• Promoting Physical Activity Notice (PDF)
• Provider Reference Guide (PDF)
• Transitional Care Management With Medication Reconciliation Post-Discharge Notice (PDF)
• Urinary Incontinence Notice (PDF)

Working with First Choice VIP Care Plus

• Care for older adults (COA) form (PDF)
• Clinical resources
• Grievances
• Integrated care management
• Provider manual (PDF)
  • Home and community-based services (HCBS) section (PDF)
• Provider Network Management Account Executive map (PDF)
• Request for Redetermination of Medicare Prescription Drug Denial
• Service area map (PDF)
• South Carolina Healthy Connections Prime
• Waiver of liability form for non-participating provider appeals (PDF)

Check back often, since we'll update this section with important provider information. If you need help or have questions, please call Provider Services at 1-888-978-0862.

If you aren't yet a participating provider and would like information about joining our network, call 1-888-978-0862.