Forms and referrals
We want to make it easy to work together so our members, and your patients, have the best experience possible. Here you can access important provider forms and learn how to refer a patient to CCA Health.
Refer a Patient
Together we can create a better experience and better outcomes for your patients with complex needs.
Provider and Network Information
Provider & Pharmacy Directory
Download:
Prescription Drugs Information
Choice and Plus Drug Formulary (2022)
Download:
Medication Transition Process
Download:
Drug Quality and Utilization Management
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Access to Care Standards Information
Claims, Billing, and Payment Information
Claim Submission Formats and Timeframes
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Claims Processing and Payment
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Member Balance Billing
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Provider Payment Dispute and Appeal Processes
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Drug Prior Authorization Request Form
Download: