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Manuals, Forms and Resources
Welcome to the Provider Resource Center
This page is designed to give you quick and easy access to everything you need as a provider with Delaware First Health. Here, you’ll find manuals, quick reference guides, contracting and credentialing resources, provider forms, and other essential tools to help you deliver the best care. Our goal is to make it simple for you to find the information and resources you need—right when you need them.
To view the contents of each section, please expand the accordion panels. Each section contains helpful links and resources tailored to your needs.
- Behavioral Health Provider Addendum (PDF)
- Contract Request Form (PDF)
- Doula Practitioner Data Form (PDF)
- LTSS Supplementary Addendum (PDF)
- Organizational Provider Application (PDF)
- Organizational Provider Roster Addendum (PDF)
- Ownership and Controls Disclosure Form (PDF)
- Practitioner Data Form (PDF)
- Provider Intake Roster Template (Excel)
- Provider Welcome Letter (PDF)
- Sample Participating Provider Agreement (PDF)
- W9 Form (PDF)
- Additional Postpartum Doula Visits Recommendation Form (PDF)
- Additional Postpartum Doula Visits Recommendation Form - Hatian Creole (PDF)
- Additional Postpartum Doula Visits Recommendation Form - Spanish (PDF)
- Behavioral Health Notification of SUD Admission (PDF)
- Certificate of Medical Necessity for Private Duty Nursing and Home Health Aide (PDF)
- Critical Incident Form (PDF)
- Delaware Sterilization Consent Form (PDF)
- Delivery Notification Form (PDF)
- EPSDT Member Outreach Form (PDF)
- Home-Based Asthma Interventions Value-Added Benefit Form
- Inpatient Medicaid Prior Authorization Form (PDF)
- Interpreter Request Form (PDF)
- Justification of Abortion Covered by Medicaid Form (PDF)
- Medical Pharmacy Prior Authoriation Form (PDF)
- Member Outreach Form (PDF)
- Missed Shift Report (Excel)
- Non-PCP Annual Attestation Form
- Notification of Pregnancy (NOP) Form (PDF)
- Outpatient Prior Authorization Form (PDF)
- Outpatient Prior Authorization Supplemental Form (PDF)
- Pediatric Respite Authorization Form (PDF)
- PCP Annual Attestation Form
- PCP Change Request Form (PDF)
- Prior Authorization Request Form for Prescription Drugs (PDF)
- Provider Appeal Form (PDF)
- Social Determinants of Health (SDoH) Mini Screener (PDF)
- Specialty Medication Prior Authorization Form (PDF)
- 2025 Provider Billing Manual (PDF) - Last Updated August 2025
- 2025 Provider Manual (PDF) - Last Updated August 2025
- Continuity of Care Program (PDF)
- Member Handbook
- Pay for Performance and Partnership for Quality (P4P/P4Q) Program Booklet (PDF)
- Payspan Guide (PDF)
- Pediatric Pay-for-Performance Guide (PDF)
- Secure Provider Portal Guide (PDF)
- Social Determinants of Health (SDoH) Program Guide (PDF)
DFH uses the Preferred Drug List (PDL)/Formulary as developed by the Delaware Medicaid Program. Please use the PDL/Formulary to find more information on the drugs that are covered.
For additional pharmacy resources such opioid calculators, medical necessity guidelines, authorization forms and more, please visit our Pharmacy webpage.
- DMMA Care Management Billing QRG (PDF)
- DMMA Implementation Review Checklist (PDF)
- DMMA Interprofessional Consultation Billing QRG (PDF)
- DMMA Interprofessional Consultation Reference Sheet (PDF)
- DMMA Trauma-Informed Care Billing QRG (PDF)
- Pre-Recorded Training Video: Reimbursement Opportunities to Support Key Perinatal Evidence-Based Practices in Outpatient Settings
- Breast Cancer Screening Tool for Office Visits (PDF)
- Claims Modifiers for Behavioral Health Services (PDF)
- Doula Quick Reference Guide (Updated October 2025) (PDF)
- EPSDT Quick Reference Guide (PDF)
- Express Scripts Pharmacy Claims Transition FAQs (PDF)
- Harm Reduction Billng Guidance (PDF)
- HEDIS® Adult Pocket Guide (PDF)
- HEDIS® MY 2025 Quick Reference Guide (PDF)
- HEDIS® MY 2025 Quick Reference Guide Addendum (PDF)
- HEDIS® Pediatric Pocket Guide (PDF)
- Home Health Quick Reference Guide (PDF)
- Medicaid Redetermination Reminder (PDF)
- Provider Engagement Administrator Contact Information (PDF)
- Provider Portal: Uploading Supplemental HEDIS Documentation (PDF)
- Provider Quick Reference Guide (PDF)
- Social Determinants of Health (SDoH) Program QRG (PDF)