Provider Manual

• Florida Provider Manual
  

Covered Services and Authorization Grid

• Florida Covered Services and Authorization Grid

Cultural Competency Plan

• Cultural Competency Plan

Language Services Request Form

• Language Service Request
  

Administrative & Claims

• CMS 1500 Claim Form Instructions
• UB 04 Claim Form Instructions
• Florida Community Based Services Medical Necessity Criteria – Adult
• Florida Community Based Services Medical Necessity Criteria – Child/Adolescent
• Chart Audit Form
• Medical Record Release Form
• Provider Change Form
• W-9 (must accompany Provider Change Form)

Florida OTR Form

• Florida Outpatient Treatment Request (OTR) Electronic Form
• Florida Outpatient Treatment Request (OTR) Manual Form

Psych Testing Forms

• Inpatient Psychological Testing Request
• Outpatient Psychological Testing Request

Clinical

• Cenpatico FARS/CFARS Memo
• Clinical Practice Guidelines
• Practice Parameters
• Intensive Outpatient/Day Treatment Form – Chemical Dependency
• Intensive Outpatient/Day Treatment Form – Mental Health

Medical Necessity Criteria

• 2010 Cenpatico Medical Necessity Criteria

Provider Portal (Online Claims)

• Cenpatico Provider Secure Portal User Manual
• Trading Partner Profile

Reference Guides

• Florida Quick Reference Guide

FAQs

• Florida FAQs

Brochures

• Keeping Children Safe in the Home
• Post Hospitalization Incentive Program for Children
• Perinatal Brochure

School Based Counseling Forms

• School Based Counseling Fax Data Request
• School Based Counseling ROI Form