PROVIDER MATERIALS

Missing materials? Below is a list of items you can access online or reprint as needed.

Provider Manual
(PDF)

Provider Registration Form (FILLABLE PDF)

Provider Claims Appeals+ Adjustments Request Form (PDF)

Provider Claim Inquiry Status Form (PDF)

Provider EOB Description List (PDF)

WHP Medication Formulary

WHP Provider Pharmacy Prior Auth Form (PDF)

WHP General Billing Information (PDF)

WHP Member Information Change Form (PDF)