Provider Resources
Trillium Community Health Plan (Trillium) provides the tools and support you need to deliver the best quality of care.
Trillium is committed to simplifying the administration of health insurance so our providers can devote their attention to providing health care.
We collaborate with our providers to efficiently deliver high-quality care throughout our community.
Trillium contracts with physicians, facilities, and other allied providers to ensure we have an adequate provider network which is essential for the delivery of healthcare services to our members. All providers must be credentialed before they can be added to our network as a participating provider.
You are invited to explore the Trillum Provider Site using the links below, or the left navigation pane.
- Manuals, Forms and Resources
- Provider Training
- Eligibility Verification
- Appeals, Grievances, and Disputes (AKA Reconsiderations and Redeterminations)
- Prior Authorization
- Policies & Criteria
- Clinical Practice Guidelines
- Preferred Drug Lists
- Risk Adjustment, Care Gaps, and Clinical Documentation
- Contracted Specialists
- Join the Trillium Network
- Health-Related Social Needs
- Medical Necessity Criteria
What's Going On?
- Visit Provider News & Updates to view notifications, including PA requirements, formulary changes, and more.
- View the Provider Orientation - Frequently Asked Questions (PDF) document for information about credentialing status, pre-authorizations, claims, and more.
- Visit the Provider Events calendar to see upcoming professional events.
- Visit the Provider Training page to learn what mandatory and optional trainings Trillium is providing.
- Coming in early 2020: Trillium is partnering with other CCOs to offer "blanket attestation" for state-mandated provider training. Notification will be forthcoming when details are available.
Helpful Links
- LineFinder - Search for a diagnosis, procedure, or service
- Find a Provider: Medicare | Medicaid - Search for a participating provider in our online Provider Directory
- NUCC Guidelines (PDF) - Instructions on how to complete the 1500 Claim form
- OHP Contraceptives Chart (PDF)
- OHP Formulary Options (PDF)
- Trillium Qualified Medicare Beneficiaries Billing (PDF)
Provider Accessibility Initiative and Survey
In order to ensure your disability access is current and accurate, we ask you to complete our Provider Accessibility Survey. Please fill it out to the best of your abilities for every service location where you serve members.