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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:

2019 Comprehensive Formulary-iCare FCP Medicaid Only-Updated 11.30.19

Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines
  • Prior Authorization
Plans
  • iCare Family Care Partnership

2019 Comprehensive Formulary-iCare FCP Plan-Updated 11.30.19

Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines
  • Prior Authorization
Plans
  • iCare Family Care Partnership

2019 Comprehensive Formulary-iCare Medicare Plans-Updated 11.30.19

Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines
  • Prior Authorization
Plans
  • Aurora CompleteCare
  • iCare Medicare Plan
  • Lakeland Care + Health

2019 P4P Measures BC

Document Types
  • Programs
Plans
  • iCare BadgerCare Plus

2019 P4P Measures SSI

Document Types
  • Programs
Plans
  • iCare Medicaid SSI

2019 Part D Prior Authorization Criteria-Updated 12.1.19

Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization

2019 Part-C5-Star Measures

Document Types
  • Programs

2019 Part-D5-Star Measures

Document Types
  • Programs

2019 Step Therapy Rx Drug Criteria-Updated 12.1.19

Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization

2020 Additional covered OTC FCP Medicaid Only

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

2020 Comprehensive Formulary all Medicare

Document Types
  • Formulary/ Pharmacy Documents
Plans
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • iCare Medicare Advantage Plan
  • iCare Medicare Plan

2020 Part D Prior Auth Criteria Updated 11.22.19

Document Types
  • Formulary/ Pharmacy Documents

2020 Step Therapy Rx Drug Criteria Updated 11.22.19

Document Types
  • Formulary/ Pharmacy Documents

Affiliation Change Form Updated 10.2.19

Document Types
  • Provider Forms

BadgerCare Plus & Medicaid SSI Mom & Baby Program

Document Types
  • Benefit Information
  • Health Education
Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Behavioral Health and AODA FAQs

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

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

Combating Medicare Fraud Waste & Abuse

Document Types
  • Policies and Guidelines

Cultural Competency Training

Document Types
  • Health Education
  • Policies and Guidelines

Cultural Competency Webinar

Document Types
  • Provider News/Bulletin

Demographic Change Form Updated 10.2.19

Document Types
  • Provider Forms

Enhanced Ambulatory Patient Grouping Announcement

Document Types
  • Policies and Guidelines
  • Provider News/Bulletin

FCP Provider Reference Manual

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

FDR Attestation Form - 2019

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

Guide for Long-Term Care Claims Processing

Document Types
  • Policies and Guidelines

Home Care Medical Outlines New CMS Documentation Initiative

Document Types
  • Policies and Guidelines
  • Provider News/Bulletin

iCare InforMED ProvideNewsletter-September2019

Document Types
  • Provider News/Bulletin

iCare Model of Care

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

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
  • Lakeland Care + Health

iCare Provider Portal User Guide

Document Types
  • Claims
  • Policies and Guidelines

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

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

Letter regarding changes to Family Care Partnership Appeals and Grievances.pdf

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

Limited English Proficiency Training

Document Types
  • Policies and Guidelines
  • Provider Forms

Medicaid-BC P4P Measures

Document Types
  • Policies and Guidelines
Plans
  • iCare BadgerCare Plus

Medicaid-SSI P4P Measures

Document Types
  • Policies and Guidelines
Plans
  • iCare Medicaid SSI

Medicare PartD Coverage Determination Request Form-Updated 1.1.19

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

Medicare Star Ratings

Document Types
  • Policies and Guidelines
Plans
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • iCare Medicare Advantage Plan
  • iCare Medicare Plan
  • Lakeland Care + Health

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
  • ALL

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

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

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 October 2018

Document Types
  • Policies and Guidelines
Plans
  • ALL

Policy CO-002 Compliance Training August 2018

Document Types
  • Policies and Guidelines
Plans
  • ALL

Portal Access Request Form

Document Types
  • Claims
  • Policies and Guidelines
  • Provider Forms

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 Request Form

Document Types
  • Prior Authorization
  • Provider Forms

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

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 Application-Medicare/Medicaid/BadgerCare

Document Types
  • Applications
  • Policies and Guidelines
  • Provider Forms
Plans
  • Aurora CompleteCare
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
  • iCare Medicare Plan
  • Lakeland Care + Health

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

Request for Redetermination of Medicare Rx Drug Denial

Plans
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • iCare Medicare Plan
  • Lakeland Care + Health

Review/Reopening Form

Document Types
  • Claims
  • Provider Forms

Status Check Request Form

Document Types
  • Claims
  • Provider Forms

Taxonomy Code Requirements

Document Types
  • Claims
  • Policies and Guidelines

Telehealth Notification Form

Document Types
  • Prior Authorization
  • Provider Forms
Plans
  • ALL

Translation Instructions for Providers & Agencies

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

Translation Instructions for Providers and Agencies

Document Types
  • Policies and Guidelines
Plans
  • ALL

Waiver of Liability Statement

Document Types
  • Policies and Guidelines
  • Provider Forms

Leaving iCareHealthPlan.org

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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