Sterling Health Plans. Real people. Wise choices

Useful materials for Windsor Medicare Extra providers:

Body Mass Index (BMI) Table
Changes to the Windsor Medicare Extra 2012 Formulary
Clinical and Preventive Practice Guidelines
Prior Authorization Part B Drugs 
Diagnosis Only Part B Drugs
Physicians Pharmacy Coverage Determinations 
Provider Frequently Asked Questions 
Provider HEDIS Guide
Provider Manual 
Quick Reference Guide  

Provider Forms

• Claim Dispute Resolution Request Form 
• Contracted Provider Reconsideration (Appeal) Form 
• Non-Contracted Provider Appeal Form 
• Pharmacy Coverage Determination Form 
• Prior Authorization Request Form 
• Provider Coverage Determination Request Form
• Provider Demographic Change Form 
• Request for Meal Delivery Form 
• Waiver of Liability Statement

Our Provider Help Desk staff is also available to assist you at 1-866-270-5223, 7 a.m. to 5:30 p.m. Central time Monday to Friday.

Useful materials for WindsorSterling providers:

Body Mass Index (BMI) Table
Changes to the WindsorSterling 2012 Formulary
Clinical and Preventive Practice Guidelines
Prior Authorization Part B Drugs
Diagnosis Only Part B Drugs
Provider HEDIS Guide
Provider Manual
Provider Frequently Asked Questions 
Quick Reference Guide 

Provider Forms

• Claim Dispute Resolution Form
• Contracted Provider Reconsideration (Appeal) Form
• Non-Contracted Provider Appeal Form 
• Pharmacy Coverage Determination Form
• Prior Authorization Request Form
• Provider Coverage Determination Request Form 
• Provider Demographic Change Form
• Request for Meal Delivery Form
• Waiver of Liability Statement

Our Provider Help Desk staff is also available to assist you at 1-888-839-9052, 7 a.m. to 5:30 p.m. Central time Monday to Friday.

Useful materials for Windsor Rx providers:

• Physicians Appeals and Grievances 
• Physicians Pharmacy Coverage Determinations
• Provider Coverage Determination Request Form
• National Provider Identifier
• Waiver of Liability Statement

Our Provider Help Desk staff is also available to assist you at 1-866-715-7519, 7 a.m. to 5:30 p.m. Central time Monday to Friday.

To access the Provider Portal:

• Windsor Health Plan Claims Status and Member Eligibility