Medicaid Managed Care Organization Diabetes Resources
DM Support Services
Condition Care for Diabetes Provider Referrals
Condition-Care-Provider-Referrals@anthem.com
Member Self-Referrals:
dmself-referral@anthem.com
Phone: 1-888-830-4300 (Dedicated Condition Care line)
Referral Form: Condition Care Referral Form (PDF)
Referral Process
Case Management
Provider Referrals: nv1cm@anthem.com
Member Self-Referrals/Phone:
1-844-396-2329
(Member Services)
Medication
Formulary
Searchable Formulary (Providers):
Formulary Search Tool
Preferred Drug List (PDL):
Nevada PDL (PDF)
Pharmacy Prior Authorization Form: Rx Prior Auth Form (PDF)
CGM Devices
CGM Benefit Policy (PDF)
Specialist
Find Network Endocrinologists: FindCare Provider Search
Other
Healthy Rewards & Value-Added Benefits
Reward Hub: Member Benefit Reward Hub
Healthy Rewards
Call Center:
1-888-990-8681
DM Support Services
Disease Management Program
Provider Services
1-833-230-2112
Referral Process
Provider Services 1-833-230-2112
Medication
Formulary
Searchable Formulary:
CareSource Pharmacy Resources
Preferred Drug List (PDL):
Nevada PDL (PDF)
CGM Devices
Prior Authorization requirements will be made available for all device products using procedurelookup.caresource.com
Other
Value-Added Benefits: Nevada CareSource for more details.
Specialist
No formal referral necessary.
Members do not need a referral to see an in-network provider, reducing the administrative burden for our providers.
Find a Doctor | CareSource
DM Support Services
Disease Management Program
702-242-7346
Referral Process
For Providers: Submit a referral to Disease Management through HPN Online Provider Center Member self-referral: Call Disease Management
702-242-7346
Medication
Formulary
Drug List (PDF): I000033222_Medicaid_UCSNVQ1 Comm & State
Searchable Drug List: Prescription drug list | OptumRx
CGM Devices
Prior Authorization:
Prior Authorizations - Provider
Other
Medicaid Benefits: Coverage and Benefits - Member
Specialist
Providers:
Submit a referral to specialist through HPN Online Provider Center
DM Support Services
Call Member Services
833-685-2102
Call Wellness Center
for information on
Value-Added Benefits (VAB)
833-685-2117
Referral Process
Email the Care Management team a referral form
NV_CM@Molinahealthcare.com
Referral Form (PDF)
Medication Formulary
Searchable Formulary:
Molina Formulary
CGM Devices
Specialist
Provider Finder
A key resource for finding providers and specialist within the Molina network is through our Provider Finder
Other
Call Wellness Center for information on Value-Added Benefits (VAB)
Phone: 833-685-2117
DM Support Services
Disease Management and Care Management Resources
Project Guardian
(remote patient monitoring)
On. Demand Diabetes (remote patient monitoring)
Referral Process
Submit a referral for these programs through SSHP Provider Portal
Send an email through SSHP Care Coordination secure email SilverSummit_CareCoordination@CENTENE.COM
Call Case Management Department with a referral
844-366-2880, option #2
Medication Formulary
Medication formulary/Preferred Drug List (PDL) is updated monthly and posted on the pharmacy section of the SSHP Website.
Use the PDF version of the PDL
CGM Devices
Specialist