Reference Materials

• 2023 Provider and Billing Manual (PDF)
  
• 2022 Provider and Billing Manual (PDF)
• 2021 Provider and Billing Manual (PDF)
  
• Quick Reference Guide (PDF)
• ICD-10 Information
• Payspan (PDF)
• Secure Portal (PDF)
• Provider Portal Enhancements: Claim Reconsideration and Denial Explanations (PDF)
• Provider Town Hall (PDF)
  
• No Surprises Act Open Negotiation Form (PDF)
  
• Ambetter Provider Claim Reconsideration/Dispute Form (PDF)

Medical Management/Behavioral Health

• Prior Authorization Guide (PDF)
• Inpatient Prior Authorization Fax Form (PDF)
• Outpatient Prior Authorization Fax Form (PDF)
• Notification of Pregnancy (NOP) Form (PDF)

Quality

• Quality Improvement (QI) Program
• Practice Guidelines (PDF)
• Cultural Competence and Linguistics Appropriate Services (CCLAS) Program (PDF)

National Imagine Associates (NIA)

• NIA Website
• NIA Quick Reference Guide (PDF)
• NIA FAQ (PDF)

New Century Health - Oncology

All oncology-related chemotherapeutic drugs and supportive agents will require prior authorization from New Century Health (NCH) before being administered in a physician’s office, outpatient hospital, or ambulatory setting.
This process applies to both Medical Benefit (Buy and Bill Request) AND Pharmacy Services (Retail Pharmacy)

Pre-Approval Process

The requesting physician must complete an authorization request using one of the following methods:

• Log in to the NCH Provider Web Portal at https://my.newcenturyhealth.com.
• Call 1-888-999-7713 and select option 1, from 8 a.m. to 8 p.m. EST, Monday through Friday. General New Century Health Information.
• New Century Health FAQ (PDF)