PRISM FAQs and GUIDES
PRISM FAQs
PRISM Release Notes
- PRISM Release Notes (updated 12.16.2024)
- 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