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. Download the Provider Manual

Quick Reference Guide

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

MedStar Family Choice Quick Authorization Guide 

A list of services that require pre-authorization.

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 Alerts

Provider alerts are frequently sent out to inform providers about changes in coverage, new policies, programs and more. 

Provider Directory

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

Provider Newsletters

Provider newsletters are sent out quarterly.

Provider Education Orientation Slides

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.

Quality Improvement Programs

This training provides details of the quality improvement programs for the Maryland HealthChoice Program.

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: 08/08/18