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Molina Healthcare of New Mexico Behavioral Health Outpatient Treatment Request Form Phone Number: (800) 3779594 Fax Number: (888) 2955494 Local Fax Number (505) 9248237 Member Information Plan: Molina
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How to fill out behavioral health outpatient treatment

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To fill out behavioral health outpatient treatment, follow these steps:
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Obtain the necessary forms and paperwork from the behavioral health facility.
03
Read and understand the instructions provided with the forms.
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Fill in your personal information accurately, including your name, contact information, and date of birth.
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Provide your insurance information if applicable.
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Answer the questions related to your behavioral health history, including any diagnoses, medications, and previous treatments.
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Make sure to include any relevant details about your current symptoms or issues you are experiencing.
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Complete any additional sections or forms requested by the facility.
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Review the filled-out forms to ensure all information is accurate and complete.
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Sign and date the forms where required.
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Submit the completed forms to the behavioral health facility and follow their instructions for further steps.

Who needs behavioral health outpatient treatment?

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Behavioral health outpatient treatment is beneficial for individuals who:
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- Have been diagnosed with mental health disorders such as depression, anxiety, bipolar disorder, or schizophrenia.
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- Experience difficulties in handling day-to-day tasks, relationships, or professional responsibilities due to their mental health condition.
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- Require additional support and therapy to manage their symptoms and improve their overall well-being.
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- Have completed inpatient treatment and need ongoing care to maintain their mental health stability.
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- Can benefit from individual or group counseling, cognitive-behavioral therapy, medication management, or other evidence-based treatments provided in an outpatient setting.
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- Seek professional help to address behavioral health concerns or emotional distress.
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Behavioral health outpatient treatment involves therapy or counseling sessions that take place on an outpatient basis, meaning the individual does not require overnight stays.
Behavioral health providers are required to file behavioral health outpatient treatment for their patients.
Behavioral health providers can fill out behavioral health outpatient treatment forms by providing detailed information about the patient's diagnosis, treatment plan, progress, and outcomes.
The purpose of behavioral health outpatient treatment is to provide individuals with the necessary therapy and support to manage their mental health conditions and improve their overall well-being.
Information that must be reported on behavioral health outpatient treatment includes patient demographics, diagnosis, treatment modalities, progress notes, and outcome assessments.
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