AppleCare Medical Group provides our physicians with frequently used forms and guides to better assist you in your practice. Please use the document library below to access any forms you may need.
- Language Assistance Program
- 2017 Combating Medicare Parts C and D Fraud, Waste, and Abuse
- 2017 Medicare Parts C and D General Compliance Training
- 2017 FWA Compliance Attestation
- 5 Star provider tip sheet
- Medicare Preventive Services Quick Reference Guide
- Code of Conduct Principles of Ethics and Integrity – Your Guide to Business
- High Risk Medications
- DMHC Pharmacy Regulation
- Prescription Drug Prior Authorization Request Form
UM decision making is based only on appropriateness of care and service and existence of coverage. AppleCare Medical Group does not specifically reward practitioners or other individuals for issuing denials of coverage or care. Financial incentives for UM decision makers do not encourage decisions that result in underutilization. Practitioners are not prohibited from advocating on behalf of the member and are advised of the following:
- The expectation to educate members regarding health needs.
- To share findings of medical history and physical exams.
- To discuss potential treatment options (including those that may be self-administered) and the risks, benefits and consequences of treatment or non-treatment.
- The side effects and management of symptoms (without regard to plan coverage).
- Recognize that the member has the right to receive sufficient information, to be able to provide input into the proposed treatment plan and has the final say in the course of action to take among clinically acceptable choices.
Practitioners are ensured independence and impartiality in making referral decisions that will not influence: [29 CFR § 2590.715-219(b)(2)(ii)(D)]. This statement is also distributed to providers along with the Affirmative Statement above.
- Any other similar matters