Provider Tools & Resources

RESOURCES AND SUPPORT

• Qualified Medicare Beneficiary (QMB) Program
• PCP Attestation Form
• Medicare Plan Benefits
• ATRIO Member Forms
• Electronic Remittance Advice (835) and EFT Authorization Agreement
• Medicare Advantage Formulary Information
• Medicare Advantage Plans Benefit Information
• Medicare Advantage Provider Directory
• Notice of Medicare Non-Coverage (NOMNC)
• Notice of Medicare Non-Coverage (NOMNC) - Instructions
• Notice of Medicare Non-Coverage (NOMNC) - SNF Checklist
• Waiver of Liability Form
• Member Appeal Form
• Member Grievance Form
• Authorized Representative Form
• Appointment of Representative Form (CMS - 1696) (For Medicare Appeals ONLY)

MEDICARE STAR RATINGS RESOURCES

View ATRIO’s Star Ratings Program page for measure descriptions and resource materials.

For questions on the Star Ratings Program, please click here to contact ATRIO Quality Improvement.

HELPFUL LINKS AND INFORMATION

These are the Coordinated Care Organizations (CCO's) that ATRIO Health Plans is partnered with in our service areas.

• Cascade Health Alliance (Klamath County)
• Umpqua Health Alliance (Douglas County)
• PacificSource Community Solutions (Marion and Polk Counties)