Provider Resources

Provider Access and Availability Requirements

Learn your requirements regarding member appointments and timeframes, and coverage for after hours.

Provider Manual

The MedStar Family Choice Provider Manual provides information on the HealthChoice program, the requirements of an MCO, and the requirements of providers participating in MedStar Family Choice.

Provider News

Provider alerts and newsletters include important information for all MedStar Family Choice providers.

Provider Support

Learn about MedStar Family Choice departments and programs that works with and assists providers.

Quick Reference Guide

For MedStar Family Choice contact numbers and information about pre-authorizations.

Interpreter Services

Interpreter for those members who have limited English proficiency, or hearing impaired, or sight impaired.

MedStar Family Choice Quick Authorization Guide 

A list of services that require pre-authorization.

Quality Monitoring Programs

The Quality Improvement Department works closely with the Maryland Department of Health to ensure our members receive optimum care.

PCP Assignment Changes

To change a member's primary care provider in our records, providers can help them complete the Member PCP Selection Form on the PCP Assignment Changes page.

Cultural Diversity Training

You can satisfy your cultural diversity training requirements by taking the education courses here.

CLAS Standards Toolkit

View the guide to implementing the National CLAS Standards.

Prior Authorization and Utilization Management

Information on prior authorization and utilization management along with forms.

Referrals

Primary care providers should use the Maryland Uniform Consultation Referral Form when referring to a specialist provider.

Provider Directory

Use our Find a Doctor tool to locate a provider near your patient.

Provider Orientation Training (On Demand)

New providers can find a variety of details about MedStar Family Choice in this training as well as department contact information.

Billing Guidelines for Developmental/Mental Health Screening and Assessment

These are Maryland Department of Health's coding guidelines for developmental/mental health screenings by primary care providers.

Clinical Practice Guidelines

A listing of clinical practice guidelines for a variety of conditions.

General Medical Records Release and Authorization Form

A form for patients to allow the release of their medical records and authorization for use or disclosure of protected health information.

HPV Public Health Issue/Tools

MedStar Family Choice needs your help in addressing the critical public health issue of under-vaccination of Maryland's adolescents and young adults against the Human Papillomavirus (HPV). The Maryland Department of Health has a variety of tools available for providers.

Living Well Program

Living Well is a seven-week MedStar Health program that helps patients with chronic conditions take charge of their health and their life.

Maryland Healthy Kids/EPSDT Program

EPSDT is the Early and Periodic Screening, Diagnosis and Treatment Program (also known as the Healthy Kids Program) through the State Medicaid Program. This program establishes preventive care standards for children under the age of 21.

Lead Testing

As a provider, it is important to follow the Lead Testing Schedule as it applies to Medicaid recipients.

Information current as of: 09/04/19