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
- BH CAHPS® Experience of Care and Health Outcomes (ECHO) Survey (PDF)
- BH Coordination of Care Checklist (PDF)
- BH Discharge Planner Checklist (PDF)
- BH Improving Patient Engagement in Behavioral Healthcare (PDF)
- BH Primary Care Provider (PCP)/ Behavioral Health (BH) Provider Communication Form (PDF)
- BH Reducing the Stigma Surrounding Mental Illness (PDF)
- 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) (01/30/2024)
- 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) (12/10/2024)
- 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)
Maximus Provider Enrollment Portal