Texas and Foster Care
Provider Manuals
Administrative & Claims
- CMS-1500 Claim Form Instructions (HCFA)
- UB-04 Claim Form Instructions
- Chart Audit Form
- Medical Record Release Form
- Primary Care Physician (PCP) Communication Form
- Provider Complaint Form
- Provider Change Form
- W-9 (must accompany Provider Change Form)
Trauma-Focused Training
- TF-CBT Online Training - Medical University of South Carolina
- Complex Trauma Series/Master Speaker Series - National Child Traumatic Stress Network
Trauma Informed Care Specialty Network
- Trauma Informed Care – Specialty Network Provider Guidelines
- Trauma Informed Care – Provider Application
To submit your Trauma Informed Care (TIC) Specialty Provider application:
Mail:
Credentialing Department
c/o TIC Specialty Provider Network Applications
Cenpatico
504 Lavaca Street, Suite 850
Austin, TX 78701
Fax:
Credentialing Department
866.694.3735
Email: Austin_cbh-credentialing@centene.com
Contact Information
Best Practice Intervention Strategies Fact Sheets
Cultural Competency Plan
Outpatient Treatment Request (OTR)
- Attention Non-Contracted Texas Providers: Please click here for an important notice regarding out-of-network authorizations taking effect on July 1, 2011.
- Risperdal Consta Request Form
- Outpatient Treatment Request (OTR)
- Outpatient Treatment Request (OTR) Tips Sheet
- Intensive Outpatient/Day Treatment Form – Chemical Dependency, Mental Health
- Outpatient Treatment Request (OTR) – Training Presentation: CHIP, RSA, STAR, and STAR+PLUS
- Outpatient Treatment Request (OTR) – Training Presentation: STAR Health (Foster Care)
Psych Testing Forms
- Texas OTR Psychological Testing – INPATIENT
- Texas OTR Psychological Testing – OUTPATIENT
- Texas Neuropsychological Testing Request Form
Electroconvulsive Therapy Form
Interpreter Request Form
Clinical
- Clinical Practice Guidelines
- Practice Parameters
- Incident Report Form
- Psychotropic Medication Care Parameters for Foster Children
- SMART Goals – Fact Sheet
Health Passport
Medical Necessity Criteria
- 2011 Cenpatico Medical Necessity Criteria – Private Day Treatment and Community-Based Services
- *Note* – Effective February 1, 2011, Cenpatico, in association with InterQual, will begin enforcing new Medical Necessity Criteria for Behavioral Health. To see answers to Frequently Asked Questions (FAQ) regarding the change, please click here.
Provider Portal (Online Claims)
- Cenpatico 837I Companion Guide
- Cenpatico 837P Companion Guide
- Full Compliance with National Provider Identifier (NPI) to be Required Effective May 23, 2008
Reference Guides
- Cenpatico CHIP Quick Reference Guide
- Cenpatico CHIP RSA Quick Reference Guide
- Cenpatico STAR Quick Reference Guide
- Cenpatico STAR MRSA Quick Reference Guide
- Cenpatico STAR+PLUS Quick Reference Guide
- Cenpatico STAR Health Quick Reference Guide
Brochures
School Based Counseling Forms
