{"id":1124,"date":"2013-04-24T07:06:36","date_gmt":"2013-04-24T07:06:36","guid":{"rendered":"http:\/\/repo.accessintegra.com\/?page_id=1124"},"modified":"2023-01-09T15:19:20","modified_gmt":"2023-01-09T15:19:20","slug":"forms-and-training","status":"publish","type":"page","link":"https:\/\/repo.accessintegra.com\/resources\/forms-and-training\/","title":{"rendered":"Forms and Training"},"content":{"rendered":"\n<hr>\n<details><summary class=\"main-sum\"><b>Resources<\/b><\/summary>\n<br><details class=\"sub-details\"><summary><strong>General Resources<\/strong><\/summary>\n<ul>\n<li><a href=\"\/wp-content\/uploads\/2022\/01\/Integra-Partners-Provider-Manual_20220120.pdf\">Integra Partners Provider Manual<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/10\/Integra-Partners-Contact-Sheet.pdf\">Contact Integra Partners<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2020\/04\/Payor COVID-Response Program.pdf\">Payer COVID-19 Response Program<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><strong>Fee Schedule Configuration Grids<\/strong><\/summary>\n<ul>\n<li><a href=\"\/wp-content\/uploads\/2022\/12\/12222022_Fee-Schedule-Document-v2.pdf\">Primary Fee Schedule<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><strong>Integra Partners&#8217; Proprietary Systems Resources<\/strong><\/summary>\n<ul>\n<li><a href=\"\/wp-content\/uploads\/2022\/10\/Que-Training-Manual-1.pdf\">Que Training Manual<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2021\/12\/Electronic-Data-Interchange-EDI-Enrollment-Information.pdf\">Electronic Data Interchange (EDI) Enrollment Information<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/01\/2022-Integra-Secondary-Claims-Submission-Process.pdf\">Secondary Claim Submission Guide<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/05\/DORI-Training-Manual.pdf\">DORI Training Manual<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/10\/Que-FAQ-1.pdf\">Que FAQ<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/10\/EDI-FAQ-1.pdf\">EDI FAQ<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><b>Training Resources from our Payer Partners<\/b><\/summary>\n<ul>\n<li><a href=\"\/wp-content\/uploads\/2019\/02\/2018 SNP MOC Provider Training.pdf\">2018 SNP MOC Provider Training<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/06\/EviCore-DME-Portal-Guide.pdf\">EviCore DME Portal Guide<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/06\/Availity-User-Reference-Guide.pdf\">Availity User Reference Guide<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><b>Prior Authorization Services Resources<\/b><\/summary>\n<ul>\n<li><a href=\"\/wp-content\/uploads\/2022\/10\/Neighborhoods-Benefit-Coverage-and-Prior-Authorization-List-of-Services-1.pdf\">Neighborhood&#8217;s  Benefit Coverage and Prior Authorization List of Services<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2023\/01\/NPI-TIN-Configuration-Guide-1.pdf\">NPI &#038; TIN Configuration Guide<\/a><\/li>\n<\/ul><\/details>\n<\/details>\n<hr>\n<details><summary class=\"main-sum\">Forms<\/summary>\n<p><strong>Below are the required forms to be used for all Integra patients.<\/strong><\/p>\n<details class=\"sub-details\"><summary><strong>Integra Partners Forms<\/strong><\/summary>\n<ul>\n<li><a href=\"\/wp-content\/uploads\/2015\/02\/Fax-cover-sheet-Integra.pdf\">Fax cover sheet<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2015\/02\/Pick-up-ticket-Integra.pdf\">Pick up ticket<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2015\/01\/Office-Staff-Update-Form-1.29.15.pdf\">Office Staff update<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2015\/02\/Satisfaction-Survey.pdf\">Patient Satisfaction Survey<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2020\/01\/INSURANCE-VERIFICATION-FORM.pdf\">Insurance Verification Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2020\/01\/Change-Date-of-Service-Form.pdf\">Change Date of Service Form<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><strong>Preauthorization Forms<\/strong><\/summary>\n<ul>\n<li><a href=\"\/pdfs\/preauthorization_forms\/1199SEIU Preauthorization.pdf\">1199SEIU Preauthorization<\/a><\/li>\n<li><a href=\"\/pdfs\/preauthorization_forms\/Anthem Preauthorization.pdf\">Anthem Preauthorization<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2020\/02\/Affinity Auth Request Form.pdf\">Affinity Auth Request Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2016\/03\/Fidelis-3.7.2016.pdf\">Fidelis Preauthorization<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2017\/06\/Healthcare-Partners-Preauthorization-1.pdf\">Healthcare Partners Preauthorization<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2017\/10\/Standard-Preauthorization-Form-v2.pdf\">Standard Preauthorization Form- Integra.pdf<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2017\/10\/WellCare-Preauth-Form-v1.pdf\">WellCare Preauthorization Medicare + Medicaid<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2020\/06\/Integra MetroPlus Authorization Request Form 122018 (1) (1).pdf\">MetroPlus Preauthorization<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/IntegraNHPPARequestForm-060523.pdf\">Neighborhood Authorization Request Form (ARF)<\/a><\/li>\n<li><a href=\/wp-content\/uploads\/2022\/05\/Emblem-Unlisted-Procedure-Code-Form.pdf>Emblem Unlisted Procedure Code Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/05\/VCM-Prior-Authorization-Request-Form.pdf\">VCM Prior Authorization Request Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/06\/SWHNY-PA-Form.pdf\">SWH NY Authorization Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2022\/06\/EmblemHealth-eviCore-DME-PA-Form.pdf\">EmblemHealth eviCore DME PA Form<\/a><\/li>\n<\/ul><\/details><\/details>\n<hr>\n<details><summary class=\"main-sum\">Integra Group Purchasing Organization (GPO)<\/summary>\n<br><details class=\"sub-details\"><summary><strong>Integra Group Purchasing Organization (GPO) Materials<\/strong><\/summary>\n<ul>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/e24000f65873d770a82a75fbd445aa05\/Integra_Procurement_Solutions_FAQ.pdf\">Integra Group Purchasing Organization (GPO) FAQ<\/a><\/li>\n<li><a href=\"https:\/\/www.docusign.net\/Member\/PowerFormSigning.aspx?PowerFormId=6659c1b0-296b-487c-be91-48be99224784&amp;env=na1&amp;acct=4858ca73-2422-493b-983b-04c4c6505a82&amp;v=2\">Integra Group Purchasing Organization (GPO) Participation Form<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><strong>Premier Materials<\/strong><\/summary>\n<ul>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/5fe542ee92015229b6cd83e267404eaf\/Premier_-_Procurement_Solutions_Vendor_FAQ.pdf\">Premier \u2013 Procurement Solutions Vendor FAQ<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/f4dd75cc81c276e328fa108ab2b3eca7\/Premier_-_Integra_One-Pager.pdf\">Premier One-Pager<\/a><\/li>\n<li><a href=\"https:\/\/www.docusign.net\/Member\/PowerFormSigning.aspx?PowerFormId=61ada146-6978-4d9d-9ba6-1fbe2b808e99&amp;env=na1&amp;acct=4858ca73-2422-493b-983b-04c4c6505a82&amp;v=2\">Premier Participation Request Form<\/a><\/li>\n<li><a href=\"\/wp-content\/uploads\/2021\/07\/Premier-Webinar-July-15-2021.mp4\">Optimize Your Supply Chain with Premier &#8211; Integra Group Purchasing Organization (GPO) Webinar<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><strong>Additional Premier Resources<\/strong><\/summary>\n<ul>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/187b2bcafabd9b021c4cc2bc863793b9\/Premier_-_GPO_Primer_-_2021.pdf\">Premier \u2013 GPO Primer \u2013 2021<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/f3b73352387fd9efd15f455496f65399\/Premier_-_Members_Benefits_-_2021_-_Co-Brand.pdf\">Premier \u2013 Member Benefits \u2013 2021<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/93cfeeacd043044dc9279fc01cfe4444\/Premier_-_Overview_-_2021.pdf\">Premier \u2013 Overview \u2013 2021<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/d34cb7b4a4f224abbcc3e140373a9db2\/Premier_-_What_to_Expect_-_2020.pdf\">Premier \u2013 What to Expect &#8211; 2020<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><strong>O&amp;P Solutions Materials<\/strong><\/summary>\n<ul>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/f241bfc0f67531c484f9f6455b593284\/O_P_Solutions_-_Procurement_Solutions_Vendor_FAQ.pdf\">O&amp;P Solutions \u2013 Procurement Solutions Vendor FAQ<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/0fb39ab398324813263a37252db0953c\/O_P_Solutions_-_Integra_One-Pager.pdf\">O&amp;P Solutions One-Pager<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/8ee445e3f7a9f9e777ab57794eb04d8b\/O_P_Solutions_Prefab_Order_Access_Code.pdf\">O&amp;P Solutions Prefab Order Access Code<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/9b49919a7e2a468e14bbf1d28f11a98f\/O_P_Solutions_and_Integra_Partners_-_Spinal_Price_List.pdf\">O&amp;P Solutions \u2013 Integra Partners \u2013 Product Price List<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/44c86be2e3cbc9918c707e78f9784c34\/O_P_Solutions_Terms_of_Sale.pdf\">O&amp;P Solutions Terms of Sale<\/a><\/li>\n<li><a href=\"https:\/\/drive.google.com\/file\/d\/10I522A4VvxvVxAXaV41yKWdMQ6eBQCZq\/view\" target=\"_blank\" rel=\"noopener\">A Commitment to Quality O&amp;P Solutions &#8211; Integra Group Purchasing Organization (GPO) Webinar<\/a><\/li>\n<\/ul><\/details>\n<br><details class=\"sub-details\"><summary><strong>CyraCom Materials<\/strong><\/summary>\n<ul>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/727a3adc1b91795c8e98d4f5ebd4c44c\/CyraCom_-_Procurement_Solutions_Vendor_FAQ.pdf\">CyraCom \u2013 Procurement Solutions Vendor FAQ<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/006d3f4fe1875e520452024ac89076f1\/CyraCom_-_Integra_One-Pager.pdf\">CyraCom One-Pager<\/a><\/li>\n<li><a href=\"https:\/\/www.docusign.net\/Member\/PowerFormSigning.aspx?PowerFormId=63938847-3450-4786-8aad-55e5350b0187&amp;env=na1&amp;acct=4858ca73-2422-493b-983b-04c4c6505a82&amp;v=2\">CyraCom End User Agreement<\/a><\/li>\n<li><a href=\"https:\/\/emma-assets.s3.amazonaws.com\/xvgbb\/eb666d95b4a74f6d25b372cfb8f4099e\/_CyraCom__Language_Code_List_digital.pdf\">CyraCom Language List<\/a><\/li>\n<\/ul><\/details><\/details>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Resources General Resources Integra Partners Provider Manual Contact Integra Partners Payer COVID-19 Response Program Fee Schedule Configuration Grids Primary Fee Schedule Integra Partners&#8217; Proprietary Systems Resources Que Training Manual Electronic Data Interchange (EDI) Enrollment Information Secondary Claim Submission Guide DORI Training Manual Que FAQ EDI FAQ Training Resources from our Payer Partners 2018 SNP MOC [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":44,"menu_order":30,"comment_status":"open","ping_status":"open","template":"","meta":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.10 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Forms and Training - Integra Partners<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/repo.accessintegra.com\/resources\/forms-and-training\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Forms and Training - Integra Partners\" \/>\n<meta property=\"og:description\" content=\"Resources General Resources Integra Partners Provider Manual Contact Integra Partners Payer COVID-19 Response Program Fee Schedule Configuration Grids Primary Fee Schedule Integra Partners&#8217; 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