Tools/Resources

Information and forms provided in this section have been developed by Suburban Health Organization (SHO) as support for risk services (M•Plan and Advantage Membership) or to support our messenger model contracting process. They apply solely to services provided by SHO.

Risk Services Resources

Used for M•Plan and Advantage Membership. These PDF forms require Adobe Reader to view.

• 1500 Claim Form
• Ancillary Directory
• Catholic Directive List
• Claim Payment for Physician Extenders
• Drug Prior Authorization List
• EDI Provider Enrollment Form
• NPI Number Submission Form
• Pre-Cert List Additions and Removals
• Prior Authorization List
• Prior Authorization Request
• Provider Claim Dispute Form
• Provider Claim Inquiry
• Provider Directory
• Provider Enrollment
• Provider Manual
• Quick Reference Card

Messenger Model Forms

Refer to the Messenger Model section of the Physician Services site to review contract support. These PDF forms require Adobe Reader to view.

• Participating Messenger Model Agreement