PRISM FAQs and GUIDES

PRISM FAQs

• FAQs for Providers on PRISM opens in a new tab

PRISM Release Notes

• • Future Proposed PRISM Release Notes (updated 10.10.2024)
    • Future PRISM Proposed Release Notes (updated 10.10.2024) 
      These are the "proposed" changes for an upcoming PRISM release and are subject to change based on prioritization of the defects and their impacts.
  • PRISM Release Notes (updated 10.28.2024)

Facilitator and User Guides

• ABA: PRISM Prior Authorization (PA) Facilitator Guide for Providers opens in a new tab
• Home Health and Private Duty Nursing Services: PRISM Prior Authorization (PA) Facilitator Guide for Providers opens in a new tab
• Hospice Admission Record Activity Guide opens in a new tab
• Outpatient Therapies: PRISM Prior Authorization (PA) Facilitator Guide for Providers opens in a new tab
• PRISM Prior Authorization (PA) Facilitator Guide for Providers opens in a new tab
• SUD: PRISM Prior Authorization (PA) Facilitator Guide for Providers opens in a new tab

Provider FAQs

• Provider FAQ: PRISM Access, Submitting Claims, Finding & Uploading Documents opens in a new tab
• Provider FAQ: Eligibility, Billing and Claims opens in a new tab
• Provider FAQ: New Choice Waivers opens in a new tab
• Provider FAQ: Prior Authorization opens in a new tab
• Provider FAQ: Electronic Data Interchange (EDI) opens in a new tab

Remittance Advice Remark Codes (RARC) opens in a new tab

Quick Reference Guides

• Enrolling a Provider with an Applicant Type of Individual Sole Proprietor opens in a new tab
• Enrolling a Provider with an Applicant Type of Rendering opens in a new tab
• Provider Enrollment: Managing the information of a Provider opens in a new tab
• Provider Enrollment: How to complete the required agreements opens in a new tab
• Document Management Portal Quick Reference Guide for Providers
• Member Eligibility Inquiry in PRISM opens in a new tab
• PRISM Reference Guide: Submitting Payment Information for Medicare or Other Insurance opens in a new tab
• Provider Reference: Information about PRISM training resources and system changes that will impact providers opens in a new tab
• Provider Account Administrator Manual opens in a new tab
• Provider Addresses and Locations opens in a new tab
• How to Avoid Provider Enrollment Closures
• Business Process Wizard-Step Remark Resolution Guide opens in a new tab
• Uploading an Attachment in PRISM opens in a new tab
• Professional DDE Claims in PRISM User Manual

Multi-Factor Authentication Process

• March 2021 Interim MIB.pdf opens in a new tab
• Multi-Factor Authentication Registration Instructions opens in a new tab