First Health Services Provider Manual and Forms
- Overview
- Definition of Terms
- Adult Acute Inpatient - Rev 12/2005
- Adult Crisis Stabilization - Rev 12/2005
- Adult Intensive Outpatient Services
- Acute Inpatient Hospitalization/Residential Treatment Care For Individuals Under 21,Certificate of Need
- Adult Intensive Outpatient Therapy Services Clinical Management Guidelines
- Appeal Process Flow Chart
- Care Coordination
- Continued Stay Review Process Flow Chart
- Montana State HospitalPartial Hospital Care - Rev 12/2005
- Partial Hospitalization Services Certificate of Need
- Prior Authorization Review Process Flow Chart
- Provider's Guide to the First Health Authorization Process
- Retrospective Reviews
Forms
The forms are available in Adobe PDF or Microsoft Word format by clicking on the corresponding link.
Acute Inpatient Services Authorization Request Form
Adobe Acrobat PDF Form
Microsoft Word Form (Fill in the blank form)
Acute Inpatient Services Continued Stay Request Form
Adult Crisis Stabilization Authorization Request Form
Adult Crisis Stabilization Continued Stay Request Form
Adult Intensive Outpatient Services Continued Stay Prior Authorization Request Form
Adult Intensive Outpatient Services Initial Prior Authorization Request Form
Clinical Eligibility Assessment For MHSP Applicants
Emergency Eligibility MHSP Assessment Form
Notification of Discharge From Services Form
Partial Hospital Care Authorization Request Form
Partial Hospital Care Continued Stay Request Form
Page last updated: 07/28/2006
