Provider Forms and Documents

Clover Information

• Clover Phone and Fax Numbers
• Clover Provider Manual
• Latest Provider Newsletter

Waiver of Liability

• Waiver of Liability

Pre-authorization

• Medicare Part B and C Pre-authorization Request Form
• Participating Provider Pre-authorization List

Plan Benefit Information

• NaviNet: Member Eligibility and Benefit Verification

Reference

• Provider Update Request Form
• Provider Tax ID Update Form
• Condition Management Guidelines
• Provider HMO Joinder
• Provider HMO Welcome Letter
• Prescription Drug Transition Policy
• Payment Disputes
• Readmissions Review Program