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Get the FIDELIS CARE'S BEHAVIORAL HEALTH DEPARTMENT - PDF Free Download

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I AUTHORIZE ADVANCED BEHAVIORAL MEDICINE (ABM), ITS AGENTS AND ITS EMPLOYEES TO RELEASE PROTECTED HEALTH INFORMATION ABOUT ME / MY CHILD TO THE RECIPIENT WHICH MAY INCLUDE ALCOHOL AND DRUG ABUSE TREATMENT;
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To fill out Fidelis Cares Behavioral Health form, follow the steps below:
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Start by obtaining the form from the Fidelis Cares Behavioral Health Program.
03
Read the instructions carefully to ensure you understand the information required.
04
Begin filling out the form by providing your personal details such as name, date of birth, and contact information.
05
Next, complete the sections related to your medical history and any medications you are currently taking.
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It is important to accurately and thoroughly answer the sections about your behavioral health concerns, symptoms, and any previous treatments or therapy.
07
If applicable, include information about your primary care physician or any other healthcare professionals involved in your care.
08
Review the completed form to ensure all information is accurate and legible.
09
Sign and date the form as required.
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Submit the filled-out form to the designated Fidelis Cares Behavioral Health Program office or provider.

Who needs fidelis cares behavioral health?

01
Fidelis Cares Behavioral Health is designed to serve individuals who require behavioral health services and support.
02
This may include individuals experiencing mental health conditions such as anxiety, depression, bipolar disorder, or substance abuse issues.
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Anyone seeking assistance for their behavioral health and meets the eligibility criteria can benefit from Fidelis Cares Behavioral Health.
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Fidelis Care's Behavioral Health is a program that provides mental health and substance abuse services to members.
Healthcare providers and facilities who are part of the Fidelis Care network are required to file Fidelis Cares Behavioral Health.
Providers need to complete the required forms and submit them electronically through the designated platform.
The purpose of Fidelis Cares Behavioral Health is to ensure that members have access to quality mental health and substance abuse services.
Providers need to report services provided, diagnoses, treatment plans, and outcomes for each member receiving behavioral health services.
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