This section is devoted to the administrative aspects of working with PBH. This section may repeat information already located in other areas within the Provider Manual. We recommend that providers distribute this to all administrative staff within their offices. This section is a step-by-step tool aimed at easing the administrative processes.
PBH recognizes the important role administrative personnel play. They are often the first contact with a practitioner office. PBH is committed to offering quality care to our members. Administrative training plays a key role in achieving this standard.
Section Highlights
Provider status/office change procedure
Referral process
Pre-Authorization Requirements
No-show Policy
Clinical Documentation Requirements
Prescription and Laboratory Procedures
Billing process
1500 Health Insurance Claim Form (HICF) Required Information
