Provider Resources

Find forms and resources to better work with us as you care for your patients.

Provider Engagement

CAHPS Provider Flier

Change Healthcare ePayment Flier

ERA EFT Sign-up Form

FCC Claim Reprocessing Inquiry Flier

Provider Change

Provider Resource Guide

5 Stars Provider Flier

Link to FCC Provider Training Recording

FCC Tapestry Link User Guide

Waiver of Liability

Pharmacy

FCC Morphine Equivalent Dose Form

FCC Self-Funded, Large Group and Transitional Small Group Formulary

FCC Small Group ACA Formulary

FMD New Hanover

FMD Sandhills

FMD Triangle

FCC Prior Authorization Form

Utilization Management

FirstCarolinaCare Prior Authorization Form

Pharmacy and Medical Drug Prior Authorization Form

SNF Clinical Checklist

SNF Clinical Checklist FAQ

Tip Sheets

Breast Cancer Screening

Child and Adolescent Well-Care Visits

Colorectal Cancer Screening

Controlling Blood Pressure

Depressive Disorder

Diabetes Mellitus

Diabetic Eye Exam

Exclusion Codes

HbA1c Poor Control

Prenatal and Postpartum Care

Statin Therapy for Patients with Cardiovascular Disease

Statin Use in Persons with Diabetes Tip Sheet

Transitions of Care-Patient Engagement After Inpatient Discharge

Transitions of Care-Receipt of Discharge Information

Transitions of Care-Notification of Inpatient Admission

Transitions of Care-Medication Reconciliation Post Discharge

Percentage of Inpatient Admissions with Follow Up Withing 14 Calendar Days

Kidney Health Evaluation for Patients with Diabetes KED

Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions

Osteoporosis Management in Women Who Had a Fracture

Depression Screening and Follow-Up on Positive Screen