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Carbon Behavioral Health, Inc./LA Care Health Plan Primary Care Provider (PCP) Referral FormReferral Date:___ Member Name:___Medical IN ID#:___DOB: ___ Parent/Guardian Name:___ Preferred Language:

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What is carelon behavioral health incla?

Carelon behavioral health incla is a form used to report information related to behavioral health services provided by Carelon.

Who is required to file carelon behavioral health incla?

Providers of behavioral health services, such as clinics, hospitals, and individual practitioners, are required to file carelon behavioral health incla.

How to fill out carelon behavioral health incla?

Carelon behavioral health incla can be filled out electronically or manually, following the instructions provided by Carelon.

What is the purpose of carelon behavioral health incla?

The purpose of carelon behavioral health incla is to collect data on behavioral health services provided by Carelon for reporting and analysis.

What information must be reported on carelon behavioral health incla?

Carelon behavioral health incla requires information on the types of services provided, number of patients served, and any outcomes or follow-up care.

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