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(formerly MH MRA of Harris County)Medicaid/Medicare Provider Interest Group Form (FOR LICENSED MENTAL HEALTH PROVIDERS ONLY)Provider Name: Provider Mailing Address: Provider Email Address: Provider
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Step 1: Download the formerly mhmra of Harris form from the official website.
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Step 2: Read the instructions carefully to understand the information required.
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Step 3: Fill out personal details such as name, address, contact information, and social security number.
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Step 4: Provide information about your medical history and any previous mental health treatments.
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Step 5: Answer the questions regarding your current mental health condition and any symptoms you may be experiencing.
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Step 6: Attach any supporting documents or medical records that may be required.
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Step 9: Submit the form to the designated authority or healthcare provider as specified in the instructions.
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Formerly MHMRA of Harris stands for the Mental Health Mental Retardation Authority of Harris County, which is now known as The Harris Center for Mental Health and IDD.
Providers, agencies, and organizations that receive funding or provide services related to mental health and intellectual/developmental disabilities in Harris County.
Formerly MHMRA of Harris forms can be filled out electronically or manually following the instructions provided by The Harris Center for Mental Health and IDD.
The purpose of formerly MHMRA of Harris forms is to collect information about services provided, funding received, and outcomes achieved in the mental health and IDD sector in Harris County.
Information such as services provided, funding sources, number of clients served, outcomes achieved, and any other relevant data related to mental health and IDD services.
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