Provider Resources
- Provider Quick Reference Guide
- Provider Forms
- Provider Manuals
- Electronic Transactions
- Eligibility Verification
- Grievance Process
- Clinical & Payment Policies
- Integrated Care
- National Imaging Associates (NIA)
- Patient Centered Medical Home Model
- Prior Authorization
- Nevada Medicaid Revalidation Documents & Reports
- Report Fraud, Waste and Abuse
- HEDIS Quick Reference Guide (PDF)
- COVID-19 Medicaid Notice of Vaccine Billing Guidelines
For any questions regarding HEDIS, please contact: Nazhrene Dator, HEDIS Coordinator at Nazhrene.Dator@SilverSummitHealthplan.com or you may also visit our QI Program page for more information.
Member Satisfaction with Provider Scorecards
To help patients engage their healthcare provider in conversations that empower them to ask questions about what tests and procedures are right for them, patient-friendly materials have been created based on the specialty societies' lists of recommendations of tests and treatments that may be unnecessary.
You can find this information at Choosing Wisely.
2021
- SilverSummit Healthplan Provider Scorecard Adult Medicaid and Ambetter (PDF)
- SilverSummit Healthplan Provider Scorecard Child (PDF)
2020
- SilverSummit Healthplan Provider Scorecard Behavioral Health Adult and Child (PDF)
- SilverSummit Healthplan Provider Scorecard Behavioral Health (PDF)
- SilverSummit Healthplan Provider Scorecard Child CHIP (PDF)
- SilverSummit Healthplan Provider Scorecard Child CCC (PDF)