Top tools for your practice

Section 1 — Member Information
Section 2 — Covered Services
Section 3 — Provider Management
Section 4 — Provider Portal 
Section 5 — Quality Management Program
Section 6 — Clinical Programs
Section 7 — Utilization Management
Section 8 — Billing Guidelines
Section 9 — Pharmacy
Section 10 — Appeals and Grievances
Appendix A — Contact Information
Appendix B — Glossary

Section 1 — Member Information
Section 2 — Covered Services
Section 3 — Provider Management
Section 4 — Provider Portal 
Section 5 — Quality Management Program
Section 6 — Clinical Programs and Utilization Management
Section 7 — Billing Guidelines
Section 8 — Pharmacy
Section 9 — Appeals and Grievances

Cardiac Imaging Prior Authorization Form
CT/CTA/MRI/MRA Prior Authorization Form
Non-Emergency Medically Necessary Ground Transportation Form
PET — PET CT Prior Authorization Form
Prior Authorization Request Form
Psychological and Neuropsychological Assessment Supplemental Form

Prior authorization form — Specialty and Non-Specialty (PDF)
Hepatitis C Medications Prior Authorization Form (PDF)
Synagis Prior Authorization Form (PDF)

HCAS provider information form
Update your directory information.

Provider info change form
Enroll or remove providers from your practice. If you're registered for our provider portal, you can use our convenient online enrollment tool instead. 
 
W9
Provide your tax identification number (TIN) to AllWays Health Partners. 

Electronic Remittance Advice Enrollment Form
MassHealth Notification of Birth Form (NOB-1)
Provider Audit Appeal Form
Request for Claim Review Form
Unlisted/NOC/NOS/NES Special Report Form

To help you deliver the very best patient care, here are some resources where you can find practice guidelines for chronic or complex conditions.

ADHD Guidelines in Primary Care for Children and Adolescents
Attention Deficit Hyperactivity Disorder in Primary Care for Children and Adolescents

Depression
Depression guidelines from the Institute for Clinical Systems Improvement

Diabetes guidelines
American Diabetes Association Guidelines

HIV-AIDS guidelines
HIV/AIDS Treatment Information Service Guidelines

Perinatal Care Guidelines (Massachusetts Health Quality Partners)
MHQP Perinatal Care Guidelines

Preventive care guidelines
Preventive Care Guidelines for Adults (Massachusetts Health Quality Partners)
Preventive Care Guidelines for Children (Massachusetts Health Quality Partners)

Other sources of guidelines
National Guideline Clearinghouse
Centers for Disease Control
National Institutes of Health
National Library of Medicine
Agency for Healthcare Research and Quality

Visit the drug alert page to find a complete list of medication recalls and safety information.

Submit claims for AllWays Health Partners members

Authorization request form for Aetna Signature, non-contracted, and PHCS providers

Authorizations request form for Optum providers 

Use these guides to help you test and setup electronic claims-related transactions with AllWays Health Partners.

270/271 Eligibility Benefit Inquiry & Response
276/277 Claim Status Request & Response
278 Heath Care Services Review – Request for Review and Response
834 Benefit Enrollment and Maintenance
835 Electronic Remittance Advice (ERA)
837 Institutional Billing
837 Professional Billing