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Substance Use Disorder Concurrent Request Form If this is a step-down request, please use form X18512R07, Substance Use Disorder Initial Review Prior Authorization Request Form. Effective May 1, 2019,

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How to fill out substance use disorder initial

01

Gather all necessary information such as medical history, current substance use, past treatments, and any co-occurring disorders.

02

Use a standardized form to document the information such as the DSM-5 criteria for substance use disorders.

03

Assess the severity of the substance use disorder using established measures such as the Addiction Severity Index (ASI) or the Severity of Dependence Scale (SDS).

04

Develop a treatment plan based on the individual's needs and goals, including referrals to specialized care if necessary.

05

Review and update the initial assessment regularly to track progress and adjust the treatment plan as needed.

Who needs substance use disorder initial?

01

Individuals who are suspected of having a substance use disorder and are seeking treatment.

02

Healthcare professionals who are providing care for individuals with substance use disorders.

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What is substance use disorder initial?

Substance use disorder initial is a form that needs to be filed to report information regarding substance use disorder of an individual.

Who is required to file substance use disorder initial?

Healthcare providers are required to file substance use disorder initial for their patients.

How to fill out substance use disorder initial?

Substance use disorder initial can be filled out by providing the necessary information about the patient's substance use disorder.

What is the purpose of substance use disorder initial?

The purpose of substance use disorder initial is to ensure that healthcare providers are aware of their patients' substance use disorder and can provide appropriate care.

What information must be reported on substance use disorder initial?

Information such as the type of substance use disorder, treatment plan, and any medications being prescribed must be reported on substance use disorder initial.

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