Provider resources PEAR PortalLearn more

Find the provider forms you need in our fully downloadable provider forms library.

Find the provider forms you need in our fully downloadable provider forms library.

Provider forms: New Jersey

Claims Requirements and Communications

Claims Appeals




Provider forms: Pennsylvania

Peer-to-peer requests

The peer-to-peer process streamlines workflows, improves cost-efficiencies, and complies with accreditation requirements. To participate in the peer-to-peer process, please complete the Peer-to-Peer Request form.

Registered Nurse Health Coach requests

If you are interested in having a registered nurse Health Coach work with your Pennsylvania patients, please complete a physician referral form or contact us at 1-800-313-8628.

Prior authorizations for medications

A request form must be completed for all medications requiring prior authorization. Please submit the applicable Prior Authorization Forms for prescription drugs.

Patient education and resources

Order paper copies of manuals, health and wellness materials, and more. Please note that claim forms, such as the CMS-1500, are not available through the Office Administration/Patient Education Resources Order Form; they are available for purchase at many local office supply stores.

Member eligibility and claim status

To verify member eligibility or check the status of a claim, please use the PEAR Practice Management on the Provider Engagement, Analytics & Reporting (PEAR) portal or call 1-800-275-2583 (PA) to access the Provider Automated System.

For all other questions and inquiries, call Customer Service at 1-800-275-2583 (PA).