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Thursday, September 09, 2010

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Library Search Results

Library For Medical Providers

Brochures:

Designated Medical Provider Program
Click Here to view pdf format of Designated Medical Provider Program(pdf 696kb)
 
Employee's Guide to Workers Compensation Claims
Click Here to view pdf format of Employee's Guide to Workers Compensation Claims(pdf 193kb)
 
Utilization Review Guide
Click Here to view pdf format of Utilization Review Guide(pdf 51kb)
 
Utilization Review Request (UR-C) Guidelines
Click Here to view pdf format of Utilization Review Request (UR-C) Guidelines(pdf 58kb)
 
What is an Independent Medical Exam?
Click Here to view pdf format of What is an Independent Medical Exam?(pdf 125kb)
 

Forms:

Brand Medication Prior Authorization Form (P2)
Click Here to view pdf format of Brand Medication Prior Authorization Form (P2)(pdf 45kb)
 
Capability Assessment - C3
Click Here to view pdf format of Capability Assessment - C3(pdf 47kb)
 
Chiropractic Progress/Final Report - C25
Click Here to view pdf format of Chiropractic Progress/Final Report - C25(pdf 37kb)
 
Customer Service Feedback Form
Click Here to view pdf format of Customer Service Feedback Form(pdf 29kb)
 
Electro Medical Device Certification Request - M5
Click Here to view pdf format of Electro Medical Device Certification Request - M5(pdf 15kb)
 
First Report of Injury
Click Here to view pdf format of First Report of Injury(pdf 40kb)
 
First Report of Injury Instructions
Click Here to view pdf format of First Report of Injury Instructions(pdf 254kb)
Click Here to view html format of First Report of Injury Instructions
Independent Exercise Program Approval Request (C59a)
Click Here to view pdf format of Independent Exercise Program Approval Request (C59a)(pdf 42kb)
 
Medical Services Dispute Resolution Request - M2
Click Here to view pdf format of Medical Services Dispute Resolution Request - M2(pdf 34kb)
 
Physician Request for Medication Prior Authorization - M3
Click Here to view pdf format of Physician Request for Medication Prior Authorization - M3(pdf 18kb)
 
Provider Request for Adjustment - M6
Click Here to view pdf format of Provider Request for Adjustment - M6(pdf 45kb)
 
Relistor Prior Authorization Form (P3)
Click Here to view pdf format of Relistor Prior Authorization Form (P3)(pdf 46kb)
 
Transitional Job Offer Form (C165)
Click Here to view pdf format of Transitional Job Offer Form (C165)(pdf 29kb)
 
Utilization Review (UR-C)
Click Here to view pdf format of Utilization Review (UR-C)(pdf 35kb)
 

Manuals:

Medical Provider's Guide
Click Here to view pdf format of Medical Provider's Guide(pdf 6418kb)
 

Medical Fee Schedules:

Medical Fee Schedules
 
Click Here to view html format of Medical Fee Schedules

Newsletters:

Medlink (2010 Spring)
Click Here to view pdf format of Medlink (2010 Spring)(pdf 1014kb)
 
Medlink (2010 Summer)
Click Here to view pdf format of Medlink (2010 Summer)(pdf 567kb)
 
MedProlink (2005 Fall)
Click Here to view pdf format of MedProlink (2005 Fall)(pdf 559kb)
 
MedProlink (2005 Summer)
Click Here to view pdf format of MedProlink (2005 Summer)(pdf 469kb)
 
MedProlink (2005 Winter)
Click Here to view pdf format of MedProlink (2005 Winter)(pdf 392kb)
 
MedProlink (2006 Fall)
Click Here to view pdf format of MedProlink (2006 Fall)(pdf 655kb)
 
MedProlink (2006 Spring-Summer)
Click Here to view pdf format of MedProlink (2006 Spring-Summer)(pdf 986kb)
 
Medprolink (2007 Spring)
Click Here to view pdf format of Medprolink (2007 Spring)(pdf 858kb)
 
MedProlink (2007 Summer)
Click Here to view pdf format of MedProlink (2007 Summer)(pdf 936kb)
 
MedProlink (2007 Winter)
Click Here to view pdf format of MedProlink (2007 Winter)(pdf 329kb)
 
MedProlink (2008 Fall)
Click Here to view pdf format of MedProlink (2008 Fall)(pdf 2322kb)
 
MedProlink (2008 Spring)
Click Here to view pdf format of MedProlink (2008 Spring)(pdf 2270kb)
 
MedProlink (2008 Summer)
Click Here to view pdf format of MedProlink (2008 Summer)(pdf 449kb)
 
MedProlink (2008 Winter)
Click Here to view pdf format of MedProlink (2008 Winter)(pdf 732kb)
 
MedProlink (2009 Fall)
Click Here to view pdf format of MedProlink (2009 Fall)(pdf 1365kb)
 
MedProlink (2009 Spring)
Click Here to view pdf format of MedProlink (2009 Spring)(pdf 580kb)
 
MedProlink (2009 Summer)
Click Here to view pdf format of MedProlink (2009 Summer)(pdf 619kb)
 
MedProlink (2009 Winter)
Click Here to view pdf format of MedProlink (2009 Winter)(pdf 608kb)
 

Other:

Explanation of Benefits (EOB) Codes
Click Here to view pdf format of Explanation of Benefits (EOB) Codes(pdf 186kb)
 
ICD-9 Codes Alphabetically
Click Here to view pdf format of ICD-9 Codes Alphabetically(pdf 58kb)
 
ICD-9 Codes by Body Part
Click Here to view pdf format of ICD-9 Codes by Body Part(pdf 70kb)
 
ICD-9 Codes Numerically
Click Here to view pdf format of ICD-9 Codes Numerically(pdf 56kb)
 
North Dakota Administrative Code - Title 92
 
Click Here to view html format of North Dakota Administrative Code - Title 92
PBM Drug Quantity Limits
Click Here to view pdf format of PBM Drug Quantity Limits(pdf 31kb)
 
PBM Drug/Product Restrictions
Click Here to view pdf format of PBM Drug/Product Restrictions(pdf 9kb)
 
PBM First Fill Product Exclusions
Click Here to view pdf format of PBM First Fill Product Exclusions(pdf 6kb)
 
PBM Quick Reference Sheet
Click Here to view pdf format of PBM Quick Reference Sheet(pdf 41kb)
 
PBM Service Guide for Pharmacists
Click Here to view pdf format of PBM Service Guide for Pharmacists(pdf 166kb)
 
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