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This is a central location providers use to find forms, publications, reference manuals and other documents essential to providing care for iCare members. Filters make it easy to find exactly what you're looking for. 

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Provider Documents that match your criteria:

2021 Additional covered OTC FCP Medicaid Only

Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
Plans
  • iCare Family Care Partnership

2021 Part D Prior Auth Criteria Updated 9/1/21

Document Types
  • Formulary/ Pharmacy Documents

2021 Step Therapy Rx Drug Criteria Updated 9/1/21

Document Types
  • Formulary/ Pharmacy Documents

Affiliation Change Form

Document Types
  • Provider Forms

Ambulance Claims

Document Types
  • Claims

BadgerCare Plus & Medicaid Mom & Baby Program

Document Types
  • Health Education
  • Programs
Plans
  • iCare BadgerCare Plus

Behavioral Health and AODA FAQs

Document Types
  • Behavioral Health
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

Borrower Paycheck Protection Program Application

Document Types
  • Provider News/Bulletin

Claim Form - LTC Professional

Document Types
  • Claims
  • Provider Forms
Plans
  • iCare Family Care Partnership

Claim Form - LTC Residential

Document Types
  • Claims
Plans
  • iCare Family Care Partnership

Clean Claim Requirements (CMS 1500)

Document Types
  • Claims
Plans
  • ALL

Clean Claim Requirements (UB-04)

Document Types
  • Claims
Plans
  • ALL

COVID 19 Claims & Coverage Webinar

Document Types
  • Claims
  • COVID-19
  • Prior Authorization

Cultural Competency Training

Document Types
  • Health Education
  • Policies and Guidelines

Cultural Competency Webinar

Document Types
  • Provider News/Bulletin

Demographic Change Form

Document Types
  • Provider Forms

DME DMS Message to Providers

Document Types
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

EFT Enrollment Check List

Document Types
  • Claims

Electronic Visit Verification Guide

Document Types
  • Internal Guidance for Providers

Enhanced Ambulatory Patient Grouping Announcement

Document Types
  • Policies and Guidelines
  • Provider News/Bulletin

F02717-EVV-Live-In Worker ID fillable form

Document Types
  • Prior Authorization
  • Provider Forms

FCP Provider Reference Manual

Document Types
  • Policies and Guidelines
  • Provider Forms
Plans
  • iCare Family Care Partnership

FDR Attestation Form

Document Types
  • Policies and Guidelines
  • Provider Forms
Plans
  • ALL

Follow to Home Program brochure

Document Types
  • Programs
Plans
  • ALL

Fraud Waste and Abuse Training

Document Types
  • Policies and Guidelines

General Subacute Communication to Providers

Document Types
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

General Telemedicine Toolkit

Document Types
  • COVID-19

Hearing Claims

Document Types
  • Claims

HMO and PIHP Member Grievances and Appeals Guide

Document Types
  • Grievances & Appeals

Home Care Medical Outlines New CMS Documentation Initiative

Document Types
  • Policies and Guidelines
  • Provider News/Bulletin

Home Health Claims

Document Types
  • Claims

Hospice Claims

Document Types
  • Claims

HPMS Memo NPPES Provider Directory 1-3-2020

Document Types
  • Policies and Guidelines
Plans
  • ALL

iCare Model of Care Guide

Document Types
  • Policies and Guidelines

iCare Personal Emergency Response System (PERS) Enrollment Form

Document Types
  • Applications
  • Policies and Guidelines
  • Prior Authorization
  • Provider Forms
Plans
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • iCare Medicaid SSI
  • iCare Medicare Plan

iCare Prior Auth Request Form

Document Types
  • Prior Authorization

iCare Provider Portal Registration Guide

Document Types
  • Policies and Guidelines

iCare Provider Portal User Guide

Document Types
  • Claims
  • Policies and Guidelines

iCare Pulmonary Artery Monitoring-CardioMems Guidance for Providers

Document Types
  • Internal Guidance for Providers
  • Policies and Guidelines
  • Prior Authorization

iCare Remit Reason Codes

Document Types
  • Claims
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

iCare Residential Availability Form

Document Types
  • Provider Forms
Plans
  • iCare Family Care Partnership

iCare Urine Drug Screen Guidance for Providers

Document Types
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

iCare Urine Drug Screen Policy

Document Types
  • Internal Guidance for Providers
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

iCare webinar-04-2021-Promoting Excellence in Assisted Living slides.pdf

Document Types
  • Programs
Plans
  • iCare Family Care Partnership

ICD10 FAQs

Document Types
  • Claims

ICD10 Links

Document Types
  • Claims

Inpatient Notification Form

Document Types
  • Policies and Guidelines
  • Provider Forms
Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
  • iCare Medicare Plan

Limited English Proficiency Training

Document Types
  • Policies and Guidelines
  • Provider Forms

Long Term Care (LTC) Claims

Document Types
  • Claims

Long Term Care Pandemic Plan Checklist

Document Types
  • Health Education
Plans
  • iCare Family Care Partnership

Medicaid SSI BC P4P

Document Types
  • Programs

Medicare Star Ratings

Document Types
  • Policies and Guidelines
Plans
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • iCare Medicare Plan

Medication Reconciliation Post-Discharge Form

Document Types
  • Formulary/ Pharmacy Documents
  • Provider Forms
Plans
  • ALL

Medication Request Form

Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization
  • Provider Forms
Plans
  • ALL

Member Handbook Changes Summary Template Draft for MCOs

Document Types
  • Grievances & Appeals
  • Policies and Guidelines
Plans
  • iCare Family Care Partnership

New Provider Education

Document Types
  • Policies and Guidelines
  • Provider News/Bulletin

Notice of Nondiscrimination

Document Types
  • Policies and Guidelines
Plans
  • Aurora CompleteCare
  • iCare BadgerCare Plus
  • iCare Family Care Partnership
  • iCare Medicaid SSI
  • iCare Medicare Plan

Ombuds Information (English)

Document Types
  • Health Education
  • Policies and Guidelines
Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Ombuds Information (Hmong)

Document Types
  • Health Education
  • Policies and Guidelines

Ombuds Information (Spanish)

Document Types
  • Health Education
  • Policies and Guidelines
Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

PA Procedure Specific Listing Q1 2021

Document Types
  • Prior Authorization

PA Request - Personal Care Worker (PCW) fillable form

Document Types
  • Prior Authorization
  • Provider Forms

Part D Coverage Determination Request

Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization
  • Provider Forms
Plans
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • iCare Medicare Plan

Part D Redetermination Request

Document Types
  • Formulary/ Pharmacy Documents

Part D Transition Process

Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization
Plans
  • ALL

PA-Testing for Drugs of Abuse

Document Types
  • Policies and Guidelines
  • Prior Authorization

PCW HHC Message to Providers

Document Types
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

PCW vs. LTC Guide

Document Types
  • Claims

Personal Care Screening Tool - Instructions

Document Types
  • Policies and Guidelines
  • Prior Authorization
  • Provider Forms
Plans
  • iCare Family Care Partnership

Personal Care Screening Tool - MS Word Format

Document Types
  • Applications
  • Prior Authorization
  • Provider Forms
Plans
  • iCare Family Care Partnership

Personal Care Screening Tool (Form)

Document Types
  • Policies and Guidelines
  • Prior Authorization
  • Provider Forms
Plans
  • iCare Family Care Partnership

Policy - Caregiver Background Check

Document Types
  • Policies and Guidelines
Plans
  • iCare Family Care Partnership

Policy CO-001 Compliance Program Policy

Document Types
  • Policies and Guidelines
Plans
  • ALL

Policy CO-002 Compliance Training Policy

Document Types
  • Policies and Guidelines
Plans
  • ALL

Policy QI-013 Quality Improvement Program Oversight

Document Types
  • Policies and Guidelines

Portal Access Request Form

Document Types
  • Claims
  • Policies and Guidelines
  • Provider Forms

PPP Borrower Information Fact Sheet

Document Types
  • Provider News/Bulletin

Practitioner Attestation

Document Types
  • Applications
  • Policies and Guidelines
  • Provider Forms

Prescriber Enrollment Update Notice from CMS

Document Types
  • Formulary/ Pharmacy Documents
  • Policies and Guidelines
  • Provider News/Bulletin

Prior Authorization Procedure Specific Listing Q1 2018 effective January 1 2018

Document Types
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

Prior Authorization Procedure Specific Listing Q3 2017 effective July 2017

Document Types
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

Prior Authorization Procedure Specific Listing Q3 2018 effective July 15 2018

Document Types
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

Prior Authorization Procedure Specific Listing Q3 2019 effective July 19 2019

Document Types
  • Policies and Guidelines
  • Prior Authorization
Plans
  • ALL

Prior Authorization Requirements - In Home Meals

Document Types
  • Policies and Guidelines
  • Prior Authorization

Prior Authorization Subacute Request Form

Document Types
  • Policies and Guidelines
  • Prior Authorization
  • Provider Forms
Plans
  • ALL

Procedure Specific Listing Q1 2020 Excel

Document Types
  • Prior Authorization

Procedure Specific Listing Q1 2020 PDF

Document Types
  • Prior Authorization

Procedure Specific Listing Q2 2020 Excel

Document Types
  • Prior Authorization

Procedure Specific Listing Q2 2020 PDF

Document Types
  • Prior Authorization

Provider Application - Durable Medical Equipment

Document Types
  • Applications
  • Provider Forms
Plans
  • ALL

Provider Application - LTC and Family Care Partnership Services

Document Types
  • Applications
  • Policies and Guidelines
  • Provider Forms
Plans
  • iCare Family Care Partnership

Provider Application - Primary and Acute Services

Document Types
  • Applications
  • Provider Forms
Plans
  • ALL

Provider Application 1-2 Bed AFH

Document Types
  • Applications
  • Provider Forms
Plans
  • iCare Family Care Partnership

Provider Application-Behavioral Health Services

Document Types
  • Applications
  • Behavioral Health
  • Policies and Guidelines
  • Provider Forms

Provider Applications List

Document Types
  • Applications

Psych Testing Guidelines

Document Types
  • Behavioral Health
  • Policies and Guidelines
  • Prior Authorization
  • Provider Forms

Reconsideration-Formal Appeal Form

Document Types
  • Claims
  • Policies and Guidelines
  • Provider Forms

Remittance Advice Guide

Document Types
  • Claims
  • Policies and Guidelines

Review/Reopening Form

Document Types
  • Claims
  • Provider Forms

SNF Claim Processing Guidelines

Document Types
  • Claims
  • Policies and Guidelines

Star Ratings Improvement Measures

Document Types
  • Policies and Guidelines

Status Check Request Form

Document Types
  • Claims
  • Provider Forms

Taxonomy Code Requirements

Document Types
  • Claims
  • Policies and Guidelines

Therapy Claims

Document Types
  • Claims

Translation Instructions for Providers & Agencies

Document Types
  • Policies and Guidelines
Plans
  • ALL
  • iCare Family Care Partnership

Vision Claims

Document Types
  • Claims

Waiver of Liability Statement

Document Types
  • Policies and Guidelines
  • Provider Forms

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By clicking this link, you may be leaving the iCareHealthPlan.org website. Independent Care Health Plan (iCare) only provides these links and pointers for your information and convenience. When you select a link to an outside website, you are leaving the www.iCareHealthPlan.org website.

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