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Attending Physician Behavioral Health Statement Aetna Life Insurance Company P.O. Box 14560 Lexington, KY 40512-4560 Complete and sign the form using BLUE or BLACK ink. 1. Patient Instructions ? The
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How to fill out behavioral health attending provider:

01
Make sure to include the full name and contact information of the attending provider.
02
Note any specific credentials or qualifications that the attending provider possesses.
03
Specify the start and end dates of the provider's involvement in the behavioral health treatment.
04
Indicate the type of services or treatment the attending provider will be providing.
05
If applicable, provide any authorization or referral numbers that may be necessary for insurance purposes.

Who needs behavioral health attending provider:

01
Individuals experiencing mental health issues or behavioral health concerns may need a attending provider to receive appropriate treatment and support.
02
Individuals who have been diagnosed with conditions such as anxiety, depression, bipolar disorder, or substance abuse may benefit from having a attending provider.
03
People who have experienced trauma, grief, or significant life stressors may also benefit from the assistance of a attending provider.
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Behavioral health attending provider is a healthcare professional who provides services related to mental health and substance abuse disorders.
Behavioral health attending provider must be filed by healthcare facilities or organizations that employ or contract with behavioral health providers.
To fill out behavioral health attending provider, you need to gather the necessary information about the attending provider, such as their name, contact details, services provided, and any relevant identification numbers. Then, you can use the designated form or online portal provided by the healthcare authority to submit the information.
The purpose of behavioral health attending provider is to track and monitor the utilization of behavioral health services, ensure regulatory compliance, and facilitate appropriate reimbursement for healthcare services.
The information that must be reported on behavioral health attending provider includes the attending provider's name, contact details, identification numbers (e.g., National Provider Identifier), details of the services provided, dates of service, and any relevant billing or coding information.
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