Формы и ресурсы

Формы

• Claims Form
  • Sample Member Claims Form
• Empire Claim Form
• Authorization for Use or Disclosure of Medical Information
• Autorización para que Beacon Health Options (Opciones de Salud de “Beacon”) divulgue información confidencial
• CMS-1500 Claims Form
• • Советы по завершению CMS 1500
• Outpatient-Review-Form
• Frequently Asked Questions (PDF)

Ресурсы

• Claim Submission
• Раскрытие информации о психическом здоровье для участников из Нью-Йорка
• Экстренные службы вне сети и счета за непредвиденные обстоятельства (только в Нью-Йорке)

Beacon Health Options uses the ASAM Patient Placement Criteria to make authorization determinations for Substance Use Care. If you have questions about a determination for Substance Use Care, click the link below.

• Введение в критерии ASAM для пациентов и семей

Beacon Health Options uses Medical Necessity Criteria to make authorization determinations for Mental Health Care. If you have questions about a determination for Mental Health Care, click the link for the level of care that applies below.
To obtain the complete ASAM medical necessity criteria for a specific level of care, please contact customer service at the number on the back of your ID card.

• Клинические критерии поведенческого здоровья

Beacon Health Options uses Beacon Health Medical Necessity Criteria to make certain public sector authorization determinations for Mental Health Care in New York. If you have questions about a determination for Mental Health Care, click the link for the level of care that applies below.