Get the free MBHO Recred Packet letter 09.doc

Reliant Behavioral Health, L.L.C. 1220 SW Morrison, Suite 600 Portland, OR 97205 503.802.9800 1.877.730.5113 (Toll-free Fax) Dear Practitioner: Enclosed is your recredentialing application. Please

How to fill out mbho recred packet letter

Who needs mbho recred packet letter?

1. Medical practitioners who are part of a Managed Behavioral Health Organization (MBHO) network.
2. Individuals who are seeking mental health or substance abuse treatment and are covered by an insurance plan that includes MBHO services.
3. Patients who have been referred to a MBHO by their primary care physician or another healthcare provider for specialized behavioral health services.

How to fill out mbho recred packet letter:

1. Begin by carefully reading and reviewing the instructions provided with the mbho recred packet letter. This will ensure that you understand the process and any specific requirements.
2. Fill out the personal information section accurately, including your full name, date of birth, address, contact details, and any other requested information.
3. Provide your insurance information, including the name of your insurance provider, policy number, group number, and any other details that may be required.
4. In the section related to your healthcare provider, provide the name, address, and contact details of the medical practitioner or facility where you are receiving treatment or have been referred to.
5. If applicable, provide information about your primary care physician or referring healthcare provider, including their name, contact information, and any additional details requested.
6. Pay close attention to any sections that require you to disclose your medical history or any previous behavioral health treatments. Fill them out accurately and provide comprehensive information to the best of your knowledge.
7. If there are specific questions or prompts related to the type of treatment you are seeking, make sure to answer them thoroughly and to the best of your ability.
8. Review the completed form before submitting it. Make sure all the required fields are filled out, and verify that the information provided is accurate and up to date.
9. If required, attach any supporting documents or records that may be necessary for your recredentialing process, such as medical reports or treatment plans.
10. If you have any doubts or questions while completing the mbho recred packet letter, don't hesitate to contact the MBHO's customer service or the dedicated contact person indicated in the instructions for assistance. Their support can help ensure a smooth and accurate completion of the form.

Remember, it's crucial to follow the specific instructions provided by your MBHO and to submit the completed mbho recred packet letter within the specified timeframe to avoid any delays in your treatment or insurance coverage.

For pdfFiller’s FAQs

What is mbho recred packet letter?

MBHO recred packet letter is a form used to request reconsideration of a denied claim under a managed behavioral health organization (MBHO) plan.

Who is required to file mbho recred packet letter?

Any healthcare provider or facility whose claim has been denied by a MBHO plan is required to file a recred packet letter.

How to fill out mbho recred packet letter?

The mbho recred packet letter should include details of the denied claim, reasons for requesting reconsideration, supporting documentation, and contact information.

What is the purpose of mbho recred packet letter?

The purpose of the mbho recred packet letter is to request a review of a denied claim by the MBHO plan and to provide additional information or evidence to support the claim.

What information must be reported on mbho recred packet letter?

The mbho recred packet letter should include details of the denied claim, patient information, dates of service, reasons for denial, supporting documentation, and any additional information that may support the claim.

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