Clinical Resources

Utilization Management (Prior Authorizations & Predeterminations)
Review information related to Utilization Management (Prior Authorizations & Predeterminations)

Behavioral Health Care Management Program
Learn more about the Behavioral Health Care Management Program

Clinical Practice Tools
Learn more about the Clinical Practice Tools

Early Childhood Intervention
Learn more about the Early Childhood Intervention

eviCore Prior Authorization Program
Learn more about the eviCore Prior Authorization Program

Other Clinical Resources Programs

Clinical Practice Guidelines

Preventive Care Guidelines/Patient Wellness Guidelines

Special Beginnings - A Maternity Program

Quality Improvement

Our Quality Improvement Department strives to provide products and services of the highest quality and value with a direct focus on meeting the needs of the customer. The process for delivery of care and services is constantly changing offering ongoing opportunities for improvement.

We support our health care provider’s efforts to provide quality services and products and believe that through monitoring and evaluation, we can work together to benefit both members and health care providers. This resource applies to our Medicaid products and was created as a reference for clinical quality improvement. To assist our providers, we also provide quality improvement tip sheets and resources for delivering quality care.