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Resources and tools for providers and health care professionals

We invite you to use this website, created especially for health care professionals, to find resources that can help you as you care for your patients. Here you can find our medical policies, stay up to date on the latest news or get training on our many tools and benefit plans.

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Provider Portal resources

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Work with us electronically

Our digital solutions offer you the fastest way to find plan information, manage tasks, check statuses and decisions — all without calling.

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News

CMS 1500 alternate fee source update

On July 1, 2025, the existing alternate fee source from RJ Health will be updated to include Wholesale Acquisition Cost.

Get SDOH screening aids and resources in one place

Learn how to easily share screening results and access SDOH tools, resources and training to better support your patients.

June 13: Claim-related documents going paperless for Kansas and Nebraska Medicaid

As of June 13, 2025, some Kansas and Nebraska Medicaid claim-related letters will go paperless.

Explore the CPT codes that need DEX Z-Codes

Review the CPT codes that require a DEX Z-Code as of April 1.

New genetic testing codes from the AMA will need prior authorization

On Sept. 1, we’ll require prior authorizations for certain genetic and molecular testing services.

June 13: Several documents going paperless

More letters and reconsiderations, pre-/post-service appeals going digital for Kentucky, Washington, D.C., Medicaid