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It' s all about employees;
always has been, always will be
.™
 

 

Total Life Assistance
Employee Assistance Programs
Behavioral Healthcare Management
Psychotropic Drug Intervention

   
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Provider Form Download Area

Please click on the form you require.  Print and fill out form.  Send completed form to our secure clinical fax at 713-781-4954.

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Application- Individual Provider.   (All therapist:  Please download the PIP Questionnaire listed below)

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Patients Rights and Responsibilities

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Explanation of Benefits - Release of Information

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MHC Responsibility and Procedures

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Clinical Feedback Form

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PIP Questionnaire

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Refer your Psychiatrist / Therapist

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Provider Manual Download Area

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Introduction

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Pre-certification – Authorization of Treatment

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Adverse Determination

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Other Services

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Billing Procedures

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Forms

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Small Enough to Know You, Large Enough to Serve You
 
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Last Update:  05/03/07