Forms

This is a library of the forms most frequently used by health care professionals. Looking for a form, but don’t see it here? Please contact your provider representative for assistance.

Provider tools & resources

• Log in to Availity
• Launch Provider Learning Hub
• Learn about Availity
• Prior Authorization lookup tool
• Prior Authorization requirements
• Claims overview
• Member eligibility & pharmacy overview
• Provider manual and guides
• Referrals
• Forms
• Training Academy
• Pharmacy information
• Electronic Data Interchange (EDI)

Interested in becoming a provider in our network?

We look forward to working with you to provide quality services to our members.

Medicaid:

Medicare Advantage:

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Availity, LLC is an independent company providing administrative support services on behalf of Wellpoint New Jersey, Inc.

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