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1 |
Phone Contact Reference » |
2 |
Benefits Summary» |
3 |
Medicaid Services Chart» |
4 |
CHP Formulary» |
5 |
NPI Application » |
6A |
NHP Referral Voucher » |
6B |
Prior Authorization Form Sample » |
7 |
Interactive Voice Response (IVR) System Instructions» |
8 |
Practice Change Form» |
9A |
Medical Review Record Review Tool Guidelines» |
9B |
Ambulatory Medical Record Review Tool» |
10A |
Metro Card Log » |
10B |
Medicaid Transporatation Prior Approval Form » |
11 |
CAGE Test» |
12 |
TWEAK Test» |
13 |
Mini Mental State Examination » |
14 |
PHQ- 9 Nine Symptom Checklist » |
15 |
Child Teen Health Program - Guidelines for Adolescent Preventive Services » |
16A |
AMA GAP Middle-Older Adolescent Questionnaire(in Spanish) » |
16B |
AMA GAP Parent/Guardian Adolescent Questionnaire(in English) » |
16C |
AMA GAP Parent/Guardian Adolescent Questionnaire(in Spanish) » |
16D |
AMA GAP - Middle-Older Adolescent Questionnaire (in English) » |
16E |
AMA GAP - Younger Adolescent Questionnaire (in English) » |
16F |
AMA GAP - Younger Adolescent Questionnaire (in Spanish) » |
17 |
Preventative Care Guidelines for Adults » |
18 |
PCAP Requirements» |
19 |
Appointment Scheduling Requirements » |
20 |
24 Hour Contact System Requirements for PCPs » |
21 |
NYS DOH AIDS INSTITUTE Material Order Form » |
22 |
Prenatal Care Notification & Home Care Authorization Form» |
23 |
NYCDOH Communicable Disease Reporting Requirements » |
24 |
Incident Report Form » |
25 |
Asthma Action Plan » |
26 |
Diagnosis,
Evaluation and Management of Adults and Children with Asthma » |
27 |
Adult Diabetes Care » |
28 |
Smoking Cessation Guidelines» |
29 |
Ambulatory Surgical Procedures Requiring Precertification» |
30 |
QARR Codes » |
31 |
Benefit Authorization and Referral Guide for Participating Providers» |
32 |
Preventing Colorectal Cancer Guidelines » |
33A |
Lead Poisoning Guidelines for Children with elevated blood levels» |
33B |
Lead Poisoning Brochure » |
33C |
NYS Regulations for Lead Poisoning Prevention and Control » |
34 |
New
York State Immunization Requirements for School Entrance/Attendance » |
35 |
Hypertension Guidelines » |
36 |
Treating Nicotine Addiction » |
37 |
Rapid HIV Test NYC DOHMH » |
38A |
Influenza Prevention & Control » |
38B |
OutPatient Testing, Treatment & Decision Algorithm for Patients with Influenza like symptoms » |
39 |
Case Management Referral Form » |
40 |
NHP Compliance Program » |
41A |
NHP Explanation of Benefits » |
41B
|
NHP Statement of Remittance » |
41C |
CHP Denial of Benefits Sample » |
41D |
Notice of Action Denial of Benefits Under Managed Care » |
41E |
FHP Action Appeal Notification Letter » |
