We value our relationship with our Providers. We constantly monitor Provider Satisfaction to ensure you are receiving the necessary information and tools required to provide our members the highest level of quality care possible. We strive to maintain open and productive relationships with you and take your input very seriously. Our extensive and qualified Provider Network in the communities we serve is testimony to the OSF HealthPlans dedication to "Managing With Care".

Click here to access the suite of iScribe web and PDA tools.

Network Notes
•	A publication for physicians, medical staff and office staff in the OSF HealthPlans network
	•  Summer 2007
	•  Winter 2006
	•  Spring 2006
What's New - Blast Fax - 2008
	•  March
	•  February
	•  January
What's New Blast Fax 2007
What's New Blast Fax 2006
Policies and Procedures
•	Administrative
	•  HMO/POS/QCP
	•  Commercial PPO
•	Medical Preauthorization
Orientation Manuals
	HMO/POS/QCP Manual
ID Cards
	QCP	ASO Parsons
	HMO	ASO Parsons Dental
	POS (same template as HMO)	ASO Great Plains
	PPO	ASO Great Plains Dental
	HDHP	ASO Schlarman
	ASO City of Peoria HMO	ASO PPO
	ASO City of Peoria PPO Blue	ASO Uftring Dental
	ASO City of Peoria PPO High Deductible
Clinical Practice Guidelines
	We are happy to provide you these links for your convenience. They will open in a new window of your browser. Please contact your OSF HealthPlans Provider Relations Specialist if you would like a hard copy of these guidelines.
•	Hypertension
•	Asthma
•	Congestive Heart Failure
•	Diabetes
•	Cholesterol
•	Acute Myocardial Infarction
•	Global Initiative for Chronic Obstructive Lung Disease
•	Major Depression for Adults
•	Major Depression in Childen/Adolescents
•	ADHD
Quality Standards - Clinical Reference Guide
•	A description of HEDIS measures included in the Quality Profiler™.
OSF HealthPlans, Inc. Provider Report View
•	Allows physicians to access clinical, quality of care and financial performance data on their practice patterns.
On-line Self Service
•	eService Site for Providers
	- Verify Patient Eligibility and Copays - View PCP and COB Information - Claim Status Lookup - Review Referral/Auth Status - On-line Referral Submission - All Information is Real-time
Physician / Provider Forms
•	eService Login Request Form
•	Provider Dispute Form
•	Provider Appeal Form - Medicare Products
•	Waiver Form
•	Request For Participation The minimum criteria necessary to join the OSF HealthPlans provider network
•	State-Mandated Credentialing Forms Illinois Department of Public Health
•	OSF HealthPlans Supplemental/Attestation/Release Forms
•	Facility and Ancillary Provider Application
•	Non-Covered Services Form
Patient Safety
•	20 TIPS to Improve the Safety of Your Patient’s Care
•	Patient Safety
•	JCAHO Official “Do Not Use” List of Abbreviations
•	National Quality Forum (NQF) Safe Practices
Members Rights
•	OSF HealthPlans Members' Rights and Responsibilities
Quick Resource Guides
•	All Plans
OSF HealthPlans' Pharmacy Benefit Information
•	City of Peoria Walgreens Formulary
•	Caremark Member Website
•	2008 Preferred Drug List Effective April 1, 2008
•	Drugs That Require Pre-Authorization
•	Drug Pre-Authorization Forms
•	Caremark SpecialtyRx Medication
OSF HealthPlans' Panel of Providers
•	Provider Directory
Subrogation Information
•	Important information about our subrogation process
HEDISฎ 2005 Report Card
•	A set of standardized performance measures to compare our performance against other managed healthcare plans
United Behavioral Health (UBH)
•	Listing of contracted UBH providers. Members must call UBH prior to accessing these providers
•	Information about care coordination between primary care and behavioral health providers
Medical Criteria
•	To request a copy of the medical criteria for procedures - or reasons for their denial
Quality Management Program
•	To request detailed information about the Quality Management Program
Department of Labor (DOL) Claims Rules
•	Frequently Asked Questions
HIPAA References
•	Centers for Medicare & Medicaid Services
•	Rule
•	Guidance
•	Trading Partner Agreement and Companion Guide -    ANSI 837 Professional Claim
E-Mail to OSF HealthPlans for Provider Services
•	providerservices@osfhealthcare.org

 

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