All of the latest forms, manuals and guidelines are available within the Provider Portal at any time.

Jade HCMG Provider Portal

All the Jade Provider forms and documents can also be found below:

Provider Manual:

Jade Provider Quick Reference Guide (PDF)
San Francisco Health Plan (SFHP) Summary of Key Information (PDF)
San Francisco Health Plan (SFHP) Attestation Form (PDF)

Jade Administrative Forms:

Authorization for Email Communication (PDF)
Direct Deposit (PDF)
Provider Information Change Form (PDF)

Compliance Training Forms:

2019 Jade Annual Compliance Training (PDF)
2019 Jade Provider Attestation Form (PDF)
San Francisco Health Plan (SFHP) Summary of Key Information (PDF)
San Francisco Health Plan (SFHP) Attestation Form (PDF)

Referral Form/Service Authorization Form (SAF) :

Prescription Drug Authorization Form (PDF) - CCHP Commercial and Covered CA Members
Medication Request Form (PDF) - CCHP Medicare Members
Consultation Referral Form (PDF)
Service Authorization Form (PDF)

ICD-10 Forms:

ICD-10 User Guide (PDF)
Common ICD-10 Chronic Conditions (PDF)

CPT Coding Information:
Preventative Care Services Guidelines (PDF)