Behavioral Health – Provider Resources

Provider Resources

Provider Manual
Provider Manual

Formulary
FORMULARY MEDICATIONS AND LABS Revision 12 04 18

Lab Requisition
(Coming Soon)

Non-TRR Services
Non Med Cvrd SRF-2018

Prior Authorization Form
Medication Prior Authorization Form Update Aug 2018

Early Refill or Greater than 30-day Supply
Early Refill or Greater than 30 Day Supply

Incident Report Form
ECI BH Incident Report Form Aug 18

Consolidated Local Service Plan (CLSP) 2018
CLSP Form O – 2018 – FINAL

Local Provider Network Development Plan (LPND) 2018
Revised LPS FY 2018 LPND