Health Services

Quick Links

• Medical Policy Manual
• Provider CARE Unit
• PHP Provider Training
• Provider Manual
• Salud/ SCI Fee Schedule
• Provider Communications
• Join Presbyterian Providers

Medical Policies 

• Medical Policy Manual

Benefit Certification Requests

If you are a contracted provider:

• with access to the Internet and Pres Online, submit your Benefit Certification Request here. If your request meets the criteria necessary for that service, Pres Online will issue you an immediate certification approval
• and do not have access to the Internet or Pres Online, print the Benefit Certification Request Form (located under Forms (Printable) and fax them to the appropriate number
• Non- Contracted Providers who do not have access to the Internet or Pres Online need to print the Benefit Certification Request Form (.pdf) and then fax them to the appropriate number.

Unsure how to submit a Benefit Certification Request?  Here is a Benefit Certification Guide (.pdf) to walk you through it.

Other forms and Information

• Notifiable Diseases/Conditions in New Mexico

Recent Communications

• Certified Diabetic Educators Contracted with PHP (.pdf)

Forms (Printable)

• Durable Medical Equipment (DME) Benefit Certification Request Form (.pdf)
• Inpatient / Outpatient Benefit Certification Request Form (.pdf)

Preventive Healthcare Guidelines (.pdfs)

• Presbyterian Health Plan Preventive Healthcare Guidelines
• Recommended "Done By One" Childhood and Adolescent Immunization Schedule - New Mexico, 2009

Clinical Practice Guidelines (.pdfs)

Asthma

• Guidelines for Diagnosis and Management of Asthma Summary
• Asthma Guidelines Full Report
• 2008 Asthma Change Page
   

Coronary Artery Disease

• Coronary Artery Disease Clinical Practice Guidelines 
• Coronary Artery Disease Clinical Practice Guidelines for Women
• ATP III 2004 Update
• Assessing Your Patient's Risk (Framingham Risk Score)
• Secondary Prevention Guidelines for patients with CAD/CVD

Diabetes 

• Diabetes Clinical Practice Guidelines for Providers - Non-Pregnant Adult
• Diabetes Clinical Practice Guidelines for Members - Non-Pregnant Adult

Obesity

• Obesity Clinical Practice Guidelines
• Adult Weight Counseling Discussion Guide
• Weight-Related Health Risk Worksheet