Documents and Forms
A
Appointment of Representative Form
B
Behavioral Health OH Commercial Prior Authorization Form
C
Claim Adjustment Coding Review Request Form
Clinical Authorization Appeal Form
D
E
Electronic Claims Waiver Request
F
Fax Inquiry Form - Benefit Inquiry Form
Fax Inquiry Form - Claims Provider Inquiry
Fax Numbers - Utilization / Care Management
Fax Request Form - Genetic Testing
Fax Request Form - Outpatient Imaging Prior Authorization
Fax Request Form - Medical Procedure / Surgery Prior Authorization
Fax Request Form - Negative Balance Report
Fax Request Form - Out of Plan Prior Auth
G
Genetic Testing and Genetic Counseling PG0041
H
HIPAA Authorization Form - Paramount
HIPAA Authorization Form - Paramount Elite Medicare
Out of Plan Home Health Care Admission Form
Out of Plan Home Health Care Discharge Notifications
Out of Plan Home Health Care Worksheet
Home Titration - E0601 Attestation Form
Hospital and Ancillary Facility Application
HRA and Action Plan Instructions
I
Interpreter ServicesMyParamount – Registration
M
MyParamount - Request for Assistance
N
Non Contracted Medicare Provider Appeal Instructions
Notice of Medicare Non-Coverage
P
Paramount Call Center Paramount Claims Entry User guide – Professional Claims
Paramount Claims Entry User guide - Institutional Claims
Paramount Claims Entry - System Administrator Guide
Paramount Trading Partner Agreement
Paramount's HIPAA Companion Guide
Practitioner Rights and Credentialing Process
Process for Inpatient Hospital Denials (PowerPoint Download)
Process for SNF/NOMNC Regarding Denials (PowerPoint Download)
Provider Information Roster (Excel Download)
Provider Information Change Form
S
Skilled Nursing Facility Concurrent Review Request
Skilled Nursing Facility Prior Authorization Form
U
Unaffected Member Request for Hereditary Cancer Genetic Testing
Utilization Management Program