Comagine Health Provider Portal
The Comagine Health Provider Portal is a web-based application for electronically submitting utilization management review requests.
Getting started: register
- Download the Comagine Health Provider Portal Registration Packet.
- Complete the following forms (in the packet) and send them to Comagine Health:
- Executive Agreement
- Provider Portal Administrator Agreement
- Provider Portal Administrator Registration
We will set up your account and email login information to you.
Guides
- User Guide (June 5, 2023)
- Administrator Guide (June 5, 2023)
- Provider Portal Administrator Training: How to Add Staff (July 2025)
- Quick Start Guide — Acute Care Hospital Requests
- Quick Start Guide — Acute Care Hospital Surgical Requests
- Quick Start Guide — Assessment Reconsideration Requests
- Quick Start Guide — CASSIP Requests
- Quick Start Guide — Collaborative Care Model Service Requests
- Quick Start Guide — Community Support Services Requests
- Quick Start Guide — Continued Stay Review Extension Requests
- Quick Start Guide — Crisis Bed Continued Stay Requests
- Quick Start Guide — Crisis Bed Review Initial Authorizations
- Quick Start Guide — Dental and Orthodontic Requests
- Quick Start Guide — DME Requests
- Quick Start Guide — DME MADs Requests
- Quick Start Guide — Eyewear and Contact Lenses Requests
- Quick Start Guide — Home Health Requests
- Quick Start Guide — Incontinence Supply Requests
- Quick Start Guide — Inpatient Level of Care Determination Requests
- Quick Start Guide — Inpatient Requests
- Quick Start Guide — LTACH Requests
- Quick Start Guide — Outpatient Requests
- Quick Start Guide — Plan of Care Requests
- Quick Start Guide — Rehabilitation Day Services Continued Stay Authorizations
- Quick Start Guide — Rehabilitation Day Services Initial Authorizations
- Quick Start Guide — SUD RTF Requests
- Quick Start Guide — Uninsured Consumers
Trainings
2026 Training and webinars
August 2026
July 2026
Comagine Health Provider Portal Training — Eyewear and Contact Lenses Requests
April 2026
April 2026
March 2026
Comagine Health Provider Portal Training — Incontinence Supply Requests
February 2026
Comagine Health Provider Portal Training — Uninsured Consumers
2025 Training and webinars
September/October 2025
2025
March 2025
2023 Training and webinars
May 2023
Comagine Health Provider Portal Upgrade Training Webinars
Utilization review criteria
In compliance with the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F), the InterQual® criteria we use for utilization review are available for viewing at this link. One-time registration is required to view the criteria – please follow the instructions to register.
Provider notices
- Bulletin 161 Qualified Diagnoses Codes for Community Support
- DME Pricing Update (July 1, 2021)
- DHCF Transmittal 21-30: Update of Select DME Fee Schedule Rates
- DHCF Transmittal 21-21: Dental Prior Authorizations
- DHCF Transmittal 17-09: Out-of-State Nursing Facility Placement and Review Procedures
- Eligibility for Medicaid Long-Term Care Nursing Facility Services
SUD residential treatment facility
- Final Rulemaking Chapter 63 — Certification Standards for Substance Use Disorder Treatment and Recovery Providers
- Substance Abuse Disorder Residential Treatment Provider Quick Reference Guide
- Substance Abuse Disorder Residential Treatment Facility Directives
- DBH Directives to Comagine Health Six-Month Rollout
Provider manual & appendices
- Medical Items and Services that Require Prior Authorization
- Appendix D-Dental Utilization Review Criteria Guidelines (June 2026)
- DC Medicaid Provider Manual
- 719A: Prior Authorization Request Form
- 1728: Intermediate Care Facility/Nursing Facility Level of Care Form
- Cone Beam Computed Tomography in Endodontics — AAE and AAOMR Joint Position Statement
Checklists & forms
- Child & Adolescent Supplemental Security Income Program Referral
- Collaborative Care Model Continued Services Review Assessment
- Community Support Services Requests Assessment Form
- Crisis Bed Services Initial Review Assessment Form
- DME, Vision and Hearing Service Providers Services Checklist
- HLD Scoresheet
- Hospice Election and Physician Certification Form
- Hospice Termination Form
- ICF/IID Recertification Checklist and Forms
- LTCAF/Rehab/SNF: Info Needed for Pre-Admission or Admission Review
- Orthodontic Continuation of Care Submission Form
- Rehabilitation Day Services Continued Stay Assessment Form
- Rehabilitation Day Services Initial Assessment Form