AultCare

Caring Professionals·Caring Providers·Caring People
Caring About Your Health

Site Directory

Members	Providers
Forms	Epocrates Formulary Tool
Change of Address Form	Forms and Guidelines
Replacement ID Card Form	834 Companion Guide
Application for Benefits Form	835 Companion Guide
AultChoice - HRA Form	837 Companion Guide
Other Coverage Form	270/271 Companion Guide
Flexible Spending Claim (Med) Form	Trading Partner Agreement
Flexible Spending Claim (Dep) Form	Insured Health Care Privacy
Full-Time Student Form	Access Request Form
Automatic Payment Deduction	Accounting Request Form
Pharmacy Information	Amendment Request Form
Provider Information	Confidential Communications
Health Assessment Tools	Request to Restrict Uses Form
Member Info (Requires Log In)	Member Info (Requires Log In)
Claim Info (Requires Log In)	Claim Info (Requires Log In)
File Transfers (Requires Log In)	File Transfers (Requires Log In)
After Hours Care	General Information
Frequently Asked Questions (FAQs)	Provider Guide
For You Discount Program	Web Maintenance
Fraud and Abuse	Evaluate Our Site
Member Guide
Web Maintenance	Employers
Evaluate Our Site	Health Care Plans
	Forms
General Information	Disability Form
Members	File Transfer Process
Employers	HIPAA Forms
Providers	Membership Report
Why AultCare?	Non Disclosure Form
Site Directory	Member Info (Requires Log In)
About AultCare	File Transfers (Requires Log In)
AultCare Affiliates	Fraud and Abuse
Individual Coverage	Pharmacy Info
Privacy Policy	Web Maintenance
Evaluate Our Site	Evaluate Our Site

Affiliates	AultCare Information
About AultCare	About AultCare
Why AultCare?	Why AultCare?
Worker's Comp.	Recognition
AultComp MCO	News
AultComp TPA	Contact Us
Statewide Coverage
Medicare
Affiliate Hospitals
Alliance Community
Aultman Hospital
Dunlap Memorial Hospital
Joel Pomerene Hospital