Provider Directory and HCBS Resources
Search for a provider in the Health Alliance Connect Medicaid Network:
Download a complete provider directory:
View the Medicaid Formulary to find Preferred Medications.
View the Medicaid Formulary to find Preferred Medications:
Send Medicaid prescriptions for eyeglasses directly to JAK Lab or Dixon Lab. JAK Lab is able to produce the eyeglasses within 30 days. You do not need to go through Health Alliance Connect for approval before sending to either of these optical labs.
- Authorization to Disclose Health Insurance Information
- Authorized Representative for Appeals
- Power of Attorney
- CVS Caremark Enrollment Forms
- Preauthorization Request Form
- Durable Medical Equipment (DME)
- Durable Medical Equipment (DME) Preauthorization Request Form
- Attestation of Training Completion (ICP, MMAI, FHP)
View the preauthorization requirements for a complete listing of procedures and equipment that require preauthorization: