Provider Forms
MBHN Clinical Forms
Medication Management Review
Medication Management Authorization Request
Claims/Billing Forms
EAP Clinical Forms
Utilization Management/Quality Improvement Forms
Sample PCP Coordination of Care Letter
Letter given to providers as a template for use in communicating with member's PCP regarding their behavioral health care treatment plan.Utilization Management Procedures for Behavioral Health Benefits for Parity Compliant Programs
Provider Practice Changes
Updating Provider Practice Information
Return along with current malpractice insurance certificate and W9