Healthy Blue Attestation Form

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Nonlicensed provider letter of attestation of trainings

(4 days ago) WEBUpon completion of this form, please return it to Healthy Blue by one of the following methods: Fax: 1-844-864-7868. Email: [email protected]. Please note: A …

https://provider.healthybluela.com/dam/publicdocuments/LALA_CAID_AttestationNonlicensedBHproviders_1.pdf

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Non-Licensed Provider Training Attestation Letter

(Just Now) WEBUpon completion of this attestation form and the Training Module Log (page two) , please return both to UnitedHealthcare via one of the following methods: • Email (preferred): …

https://ldh.la.gov/assets/docs/BehavioralHealth/Modules/UHCAttestationLetter.pdf

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Aetna Better Health of Louisiana Non-licensed provider letter …

(7 days ago) WEBUpon completion of this form, please return it to Aetna Better Health of Louisiana via one of the following methods: • Fax 1-844-634-1109 • Email AetnaBetterHealthofLA …

https://ldh.la.gov/assets/docs/BehavioralHealth/Modules/BH-attestation-LA.PDF

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Quick start guide - Healthy Blue Louisiana Medicaid

(5 days ago) WEBAfter-hours care. Call our 24/7 NurseLine anytime, anywhere, even on holidays, at 866-864-2544 (TTY 711). You may also call our 24-hour Behavioral Health Crisis Line at 844-812 …

https://www.myhealthybluela.com/la/lala_caid_newwelcomebrochurebhso_eng.pdf

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Healthy Blue + Medicare HMO D-SNP Providers Blue Cross NC

(1 days ago) WEBCase management (medical & drug) Phone: 866-611-4287. Fax: 855-443-7821. Healthy Blue + Medicare. 3350 Peachtree Road NE. Atlanta, GA 30326. View our Healthy Blue …

https://www.bluecrossnc.com/providers/networks-programs/blue-medicare/healthy-blue-medicare

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Personal Care Service (PCS) Referral FAQ

(8 days ago) WEBQ: Does Blue Cross NC require a specific form to request or refer a Healthy Blue member for a PCS evaluation? A: No, Blue Cross NC does not require a specific form to submit …

https://provider.healthybluenc.com/docs/gpp/HBNC_HBTC_PersonalCareProvIntakeFAQ.pdf?v=202109102148

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Healthy Blue Attestation of Training Form

(Just Now) WEBUpon completion of this form, please return it to Healthy Blue by one of the following methods: Fax: 1-844-864-7868 Email: [email protected] Please note: A copy …

https://form.jotform.com/230364379642056

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Non-licensed Behavioral Health Provider Training Attestation

(Just Now) WEBReturn your completed attestation to Louisiana Healthcare Connections via email to: [email protected]. A copy of this signed letter of …

https://www.louisianahealthconnect.com/content/dam/centene/louisiana-health-connect/pdfs/medicaid-provider/Nonlicensed_Behavioral_Health_Provider_Training_Attestation.pdf

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Manual, Guides and Forms Healthy Blue of South Carolina

(3 days ago) WEBMenu. Manuals, Guides and Forms. Image. Provider Office Manual. The provider office manual offers key administrative information, including the quality improvement …

https://www.healthybluesc.com/providers/resources/manual-guides-and-forms

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Prior Authorization Request For Behavioral Health Inpatient: …

(Just Now) WEBFor Behavioral Health Outpatient: 844-429-9636 Prior Authorization Request https://provider.healthybluenc.com Healthy Blue is a Medicaid plan offered by Blue …

https://provider.healthybluenc.com/docs/inline/HBNC_Forms_PA_PriorAuthRequestForm.pdf?v=202106091942

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Outline of Personal Care Services Referral/Intake Process

(3 days ago) WEBFaxing a request directly to the Long-Term Services and Supports (LTSS) Team at 844-432-5882. Submitting a secure email to the LTSS inbox at …

https://provider.healthybluenc.com/docs/gpp/HBNC_HBTC_PersonalCareServices.pdf?v=202111081530

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Materials and forms for Providers Aetna Medicaid Louisiana

(4 days ago) WEBFind all the forms a member might need — right in one place. Go to member forms. Aetna Better Health of Louisiana. Providers, get materials and forms such as the provider …

https://www.aetnabetterhealth.com/louisiana/providers/materials-forms.html

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Prior Authorization Healthy Blue of South Carolina

(9 days ago) WEBSometimes we ask other companies that are not part of Healthy Blue to help us decide if care is proper. Some examples are those who are experts in the use of X-rays and other …

https://www.healthybluesc.com/prior-authorization

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Behavioral Health Standardized Basic Training Modules for …

(2 days ago) WEBPlease complete and sign the attestation forms for the plans with whom your agency contracts and submit them following the directions provided on the forms. …

https://ldh.la.gov/page/behavioral-health-standardized-basic-training-modules-for-unlicensed-providers

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