Provider Resources
Find downloadable guides, authorization tools, claims tools, request forms & more.
Beginning February 9, 2026, all Clover Health portal functionality will be managed exclusively through Availity Essentials. To avoid any disruption to your administrative workflows, please transition to Availity Essentials as soon as possible.
Prior Authorization Tools
see Prior Auth details.
Online Authorization Tool User Guide
Continuity of Care Provider Notice
April 6,2024 Utilization Management Update
January 1, 2024 Utilization Management Update
Peripheral Vascular Intervention - Utilization Management Update
Clover Health Vascular Intervention Frequently Asked Questions
Clover Health Peripheral Vascular Intervention Provider Orientation
Clover Health Provider Orientation Invitation
UM Prior Authorization List
eviCore Prior Authorization Guidelines
Novologix Provider Support
Novologix NCCN Provider User Authorization Guide
Novologix NCCN Provider Support
Novologix NCCN Provider Notification
Clover Novologix NCCN Guidelines
Prior Authorization Request Form
Medicare Part B RX Prior Authorization Form
Clover Clinical Update Form
Medical Review Criteria Policies
Resources
Provider Quick Reference Guide
Clover Health Policies
Care Connection Newsletter
Find Clover providers for referrals
270 and 271 Requirement
National Coverage Determination on PrEP for HIV Prevention
Novologix Part B PA Policies
Step Therapy for Part B Drugs
Formulary (Pharmacy and Part D)
Part D Coverage Determinations, Exceptions, Grievances, and Appeals
HEDIS Provider Cheat Sheet
Clinical Informational Resources
Claims and Appeal Dispute Form
Waiver of Liability Statement
Guide to Covered Formulary Drug Alternatives