Mission, Values, Goals
Commitment to Providers
Quality Oversight Structure
2010 Tribute PFFS and Tribute Enhanced PFFS Plans
2010 Tribute Pride PFFS (MA Only) Plan
2010 Tribute Select PPO Plan
Glossary of Terms
Member Rights and Responsibilities
Medicare Drug Coverage Rights
Drug Exception Process
Medication Therapy Management Program
Grievance & Appeal Process
How To Obtain An Aggregate Number of Grievances
Terms and Conditions of Payment
Provider Reinbursement Grid
2010 Benefit Grid for Tribute Plan
2010 Benefit Grid for Tribute Enhanced Plan
2010 Benefit Grid for Tribute Pride Plan
2010 Benefit Grid for Tribute Select Plan
2010 Terms and Conditions of Payment
Diabetes Patient Guide
Diabetes Knowledge Briefs
CHF Patient Guide
Important Questions to Ask Providers
FORMS
Appointment of Representation Form.pdf
Grievance and Appeal Form.pdf
Request for Medicare Prescription Drug Coverage Determination Form.pdf
Instruction for Completing Appointment of Representation Form.pdf
Instructions on How To File A Grievance.pdf
Instructions for Submitting a Request for Medicare Prescription Drug Coverage Determination Form.pdf
Medicare Redetermination Request Form.pdf
Medication Exception Request Form.pdf
Prior Authorization Request Form for Aranesp, Epogen, and Procrit.pdf
Prior Authorization Request Form for Provigil.pdf
Prior Authorization Request Form for Singulair.pdf
Tier Exception Request Form.pdf
Transition Policy 2010.pdf
GHC0910 (H4917); (H9779) CMS Approved 11/17/2009