Provider Information >> Forms / Checklist

Provider Information

Provider Forms

New Provider Application

Provider Update Form

 

Formulary / Rx Drug Lists

For Employer Plans

For Medicare Advantage Plans

 

Authorization Forms

Prior Authorization Form - Cox II

Prior Authorization Form - Non-Sedating Antihistamines

Prior Authorization Form - Proton Pump Inibitor

Precertification Documentation Form

 

Provider Checklists

Required Authorization List - (Effective 11/01/2011)

Adult, Childhood & Prenatal Preventive Health Guidelines (11/04/2010)

Kentucky Terms and Conditions

 

WHP Provider Web Portal*

* This Service is for WHP Contracted Providers Only

Web Portal Request Form

Super User Instructions

How to Register as a Standard User

 

Fraud, Waste and Abuse (FWA)

Fraud, Waste and Abuse (FWA) Training Materials

Fraud, Waste and Abuse (FWA) Attestation Form