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Provider Manuals
FPACT - Family PACT Policies, Procedures and Billing Instructions Manual
Family PACT Letter (00letter)
(Revision Date May 29, 2020) | (232KB)
How to Use This Manual (0B hw to use)
(Revision Date Sep 16, 2020) | (371KB)
Family PACT Manual Table of Contents (1toc fpact)
(Revision Date May 29, 2020) | (126KB)
Benefits: Clinical Services Overview (ben clinic)
(Revision Date Aug 14, 2020) | (122KB)
Benefits: Family Planning (ben fam)
(Revision Date Sep 16, 2020) | (616KB)
Benefits: Family Planning-Related Services (ben fam rel)
(Revision Date Nov 16, 2020) | (251KB)
Benefits Grid (ben grid)
(Revision Date Nov 16, 2020) | (502KB)
Claim Completion: CMS-1500 (claim cms)
(Revision Date Aug 31, 2020) | (6030KB)
Claim Completion: UB-04 (claim ub)
(Revision Date Sep 16, 2020) | (577KB)
Client Eligibility (client elig)
(Revision Date Aug 31, 2020) | (310KB)
Clinic Formulary (clinic)
(Revision Date Sep 16, 2020) | (421KB)
Drugs: Onsite Dispensing Billing Instructions (drug)
(Revision Date Aug 14, 2020) | (199KB)
Drugs: Onsite Dispensing Price Guide (drug onsite)
(Revision Date Sep 16, 2020) | (174KB)
Family PACT Program Overview (fam)
(Revision Date Aug 14, 2020) | (138KB)
Health Access Programs (HAP) Cards (hap cards)
(Revision Date Jan 15, 2021) | (226KB)
Laboratory Services (lab)
(Revision Date Dec 16, 2020) | (403KB)
Office Visits: Evaluation and Management and Education and Counseling (office)
(Revision Date Aug 14, 2020) | (166KB)
Pharmacy Billing Overview (pharm)
(Revision Date Aug 31, 2020) | (151KB)
Pharmacy Formulary (pharmacy)
(Revision Date Oct 15, 2020) | (355KB)
Program Standards (prog stand)
(Revision Date Aug 31, 2020) | (231KB)
Provider Enrollment (prov enroll)
(Revision Date Aug 31, 2020) | (152KB)
Provider Relations Directory (prov rel)
(Revision Date Aug 31, 2020) | (193KB)
Provider Responsibilities (prov res)
(Revision Date Aug 31, 2020) | (192KB)
Radiology Services (radi)
(Revision Date Aug 31, 2020) | (94KB)
Treatment Authorization Request (TAR)
(Revision Date Jan 15, 2021) | (88KB)
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