Medical, Pharmacy & Behavioral Health

Presbyterian provides a compilation of forms and documents frequently requested by providers. If you cannot find the material you need, please contact your Provider Network Management Relationship Executive, or log onto the myPRES provider portal to submit your inquiry.


Preventive Health Guidelines

Preventive Healthcare Guidelines are evidence-based, systematically developed statements designed to provide practitioners and members with age-and gender-based recommendations about services that should be routinely incorporated into primary medical care. In considering individual member’s needs, please refer to member’s individual services/plans.

Presbyterian Health Plan has adopted the following Preventive Health Guidelines:

Adult and Children Preventive Services Practice Guidelines

Adult and Children Immunization Guidelines

TriCore Reference Laboratories Information

Forms & Documents

Tobacco Cessation Benefits Enhanced

Presbyterian has enhanced its tobacco cessation benefits for members with full medical coverage by allowing free access to the Clickotine smartphone application. Clickotine provides personalized support that allows members to create their own quit-smoking plan and build habits necessary to overcome nicotine cravings. Choose a link below for more information.

Members can also connect with a National Cancer Institute LiveHelp specialist and get immediate information and answers about quitting smoking. LiveHelp is available at 877-44U-QUIT (877-448-7848) from 7:00 a.m. to 7:00 p.m. Mountain time.


National Drug Code (NDC) Procedure Manual

When submitting claims, Presbyterian requests that all practitioners and providers for all lines of business supply the 11-digit National Drug Code (NDC) when billing for injections and other drug items on the CMS1500 and UB04 claim forms as well as on the 837 electronic transactions. Please see the updated NDC Procedure Manual for reference.

Pharmacy Forms

Centennial Care Provider Directories

Medication Therapy Management

Real-Time Prescription Benefits Tool

Behavioral Health

Behavioral Health Clinical Practice Guidelines

Last reviewed: 12/09/2022

Behavioral Health Reference Material

Care Coordination