BH Resources

Behavioral Health Resources

• Applied Behavioral Analysis (ABA) Form (PDF)
• ABA Behavior Assessment and Plans Tip Sheet (PDF)
• ABA Caregiver Training Tip Sheet (PDF)
• ABA Coordination of Care Tip Sheet (PDF)
• ABA Medication Management Tip Sheet (PDF)
• ABA Outpatient Treatment Request (OTR) Tip Sheet (PDF)
• ABA Prescription Fulfillment Tip Sheet (PDF)
• ABA Transition Planning Tip Sheet (PDF)
• Behavioral Health Bulletins
• Certificate of Need for Psychiatric Residential Treatment Facility (PDF)
• Critical Incident Report Form (PDF)
• Disease Management Referral (PDF)
• Electroconvulsive Therapy (ECT) Form (PDF)
• Inpatient Medicaid Prior Authorization (PDF)
• Intensive Outpatient Mental Health/Chemical Dependency Form (PDF)
• Medicaid Rehab Option (MRO) Request (PDF)
• Neuro Psychological Testing OTR Form (PDF)
• Outpatient Medicaid Prior Authorization (PDF)
• Outpatient Treatment Request (OTR) General BH (PDF)
• Outpatient Treatment Request (OTR) Non-Par (PDF)
• Outpatient Treatment Request (OTR) Tip Sheet (PDF)
• Provider Claim Appeal Form (PDF)
• Provider Incomplete Information Fax (PDF)
• Provider Reconsideration Form (PDF)
• Wellness Plan (PDF)

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