bhcsproviders.acgov.org - /providers/Forms/SUD/
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12/2/2019 3:05 PM 556122 ACBH SUD Full Medical Necessity CQRT Tool v.11.1.2019 (fillable).pdf
8/13/2018 11:00 AM 99374 ALOC_Initial_Assessment.dotx
8/13/2018 11:01 AM 99425 ALOC_Re-Assessment.dotx
7/6/2018 11:07 AM 581444 Authorization_Disclose_SUD.pdf
8/13/2018 11:43 AM 107160 BHCS_SUD_CQRT_Authorization_Form_Revised_Substance_use_Services_Definitions_080218_2_sided_v.7.23.1_8_Fillable.dotx
8/17/2018 2:54 PM 789609 Client_Health_Question_Init_Screening.pdf
9/27/2017 10:15 AM 118612 Color Code for Chart_Tagging.docx
8/15/2018 9:40 AM 137503 Color_Code_Chart_Tagging.pdf
9/27/2017 10:15 AM 118612 Color_Code_for_Chart_Tagging.docx
6/26/2018 12:32 PM 71797 Consumer_Grievance_Appeal_Sys.pdf
8/13/2018 11:02 AM 40537 Continuing_Services_Just.dotx
8/13/2018 11:02 AM 33660 Continuing_Services_Just_Rec_only.dotx
8/13/2018 11:02 AM 40537 Continuing_Services_Justification.dotx
8/13/2018 11:02 AM 33660 Continuing_Services_Justification_Rec_only.dotx
11/27/2019 3:47 PM 418331 CQRT Attendance Sheet.pdf
11/27/2019 3:47 PM 420747 CQRT Comments Sheet.pdf
11/27/2019 3:47 PM 604658 CQRT Minutes Sheet.pdf
3/1/2019 5:38 PM 54774 CQRT_Attendance_Sheet.docx
9/6/2018 9:48 AM 119889 CQRT_BHCS_Authorization_Form.docx
8/15/2018 9:29 AM 194446 CQRT_Chart_Review_Legend.pdf
8/13/2018 11:42 AM 102718 CQRT_Combined_BHCS_Regz_Compliance_7.23.18_Fillable.dotx
7/23/2018 1:25 PM 16734 CQRT_comment_sheet.docx
3/1/2019 5:38 PM 279298 CQRT_Minutes_Sheet.docx
11/27/2019 3:47 PM 408395 Disallowance Tracking Sheet.pdf
7/23/2018 1:37 PM 18183 Disallowance_Code_Tracking_Sheet.docx
7/23/2018 1:37 PM 18183 Disallowance_Tracking_Sheet.docx
7/2/2018 10:18 AM 29885 Disch_Summary.docx
8/13/2018 11:06 AM 30098 Disch_Summary.dotx
8/7/2017 8:13 AM 363215 Disch_Summary_form.pdf
8/13/2018 11:03 AM 46278 Discharge_Plan.dotx
7/2/2018 10:18 AM 43829 Discharge_Plan_SUD.docx
7/25/2018 3:27 PM 44091 Discharge_Plan_SUD.dotx
8/7/2017 8:13 AM 535478 Discharge_Plan_SUD.pdf
8/13/2018 11:06 AM 30098 Discharge_Summary.dotx
7/2/2018 10:18 AM 44912 Drug_Testing.docx
6/26/2018 2:59 PM 406716 Grievance_Appeal_Info.pdf
11/13/2019 1:02 PM 5510534 Grievance_Appeal_Poster.pdf
7/15/2022 1:12 PM 3420445 Grievance_Appeal_Poster_AR.pdf
6/26/2018 12:32 PM 167560 Grievance_Form.pdf
8/13/2018 11:06 AM 26764 Group_Sign-In_Sheet.dotx
8/13/2018 11:06 AM 26764 Group_Sign_In_sheet.dotx
7/6/2018 1:24 PM 39665 Group_Sign_In_Sheet.pdf
7/6/2018 11:07 AM 73100 History_Physical_Exam.pdf
1/2/2019 9:51 AM 620631 Incidental_Disclosure_Clt_Ack.pdf
8/13/2018 11:08 AM 18186 Incidental_Disclosure_form_Clt_Acknowledgement_080318.docx
12/11/2018 11:22 AM 440832 Informing_Materials.doc
6/26/2018 2:59 PM 834577 Informing_Materials.pdf
7/2/2018 10:18 AM 39063 Initial_Med_Nec_Form.docx
7/25/2018 3:01 PM 39587 Initial_Med_Nec_Form.dotx
8/4/2017 8:19 AM 619188 Initial_Med_Nec_Form.pdf
8/13/2018 11:10 AM 39698 Initial_Medical_Necessity.dotx
4/6/2017 7:54 AM 56483 INTAKE_AND_ASSESSMENT.docx
4/5/2017 11:22 AM 21653 Just_for_Tx_Form.docx
8/7/2017 8:25 AM 611845 Just_for_Tx_Form.pdf
9/27/2017 10:16 AM 13940 LABELS_CQRT_Chart_Review_Legend.docx
4/6/2017 8:07 AM 21450 Med_Nec_Form.docx
8/4/2017 8:27 AM 360789 Non-Weekly_Progress_Note_Template.pdf
11/27/2019 3:47 PM 371941 OS_IOS_Brief_MN_CQRT_Template.pdf
8/5/2019 2:49 PM 11467578 OTP Training PPT 7-30-19.pptx
8/13/2018 11:19 AM 83275 Progress_Note _Daily_RES.dotx
7/2/2018 11:35 AM 83185 Progress_Note_Daily_RES.docx
8/13/2018 11:19 AM 83275 Progress_Note_Daily_RES.dotx
8/13/2018 11:20 AM 82867 Progress_Note_Daily_WM_RES.dotx
7/2/2018 11:35 AM 53967 Progress_Note_Group_Service_OS_IOS_RS.docx
7/31/2018 3:53 PM 55114 Progress_Note_Group_Service_OS_IOS_RS.dotx
8/13/2018 11:20 AM 55154 Progress_Note_Group_Service_OS_IOS_RSS.dotx
1/7/2019 1:00 PM 42682 Progress_Note_Info_Only.dotx
8/13/2018 11:22 AM 42256 Progress_Note_Information_Only.dotx
7/2/2018 11:35 AM 42150 Progress_Note_Non_billable.docx
7/2/2018 11:35 AM 48927 Progress_Note_Single_Service_OS_IOS_RS.docx
7/25/2018 3:09 PM 48957 Progress_Note_Single_Service_OS_IOS_RS.dotx
8/13/2018 11:23 AM 49093 Progress_Note_Single_Service_OS_IOS_RSS.dotx
8/13/2018 11:24 AM 46582 Progress_Note_Single_Service_RES.dotx
7/2/2018 11:35 AM 43955 Progress_Note_Single_Service_WM.docx
7/25/2018 3:04 PM 81823 Progress_Note_Single_Service_WM.dotx
8/13/2018 11:24 AM 44408 Progress_Note_Single_Service_WM_RES.dotx
4/5/2017 12:58 PM 18200 Progress_Note_Template.docx
8/5/2019 2:49 PM 72494 Provider Log of MAT Drug Services.pdf
7/6/2018 11:07 AM 106799 Referral_Physical_Exam.pdf
6/26/2018 2:59 PM 511209 Release_Info.pdf
11/27/2019 3:09 PM 516525 RES Structured Activity Prog Requirements.pdf
8/10/2018 4:27 PM 17733 ROI_Tracker_5th_rev _8-10-18.xlsx
8/21/2018 9:32 AM 630252 Service_Definitions_DMC_ODS_ver_08-15-18.pdf
11/27/2019 3:47 PM 131766 Steps_Completing_SUD_CQRT_Forms.pdf
7/23/2018 12:50 PM 41984 Steps_to_Co_ACBHS_SUD_CQRT_Forms.doc
11/1/2018 9:40 AM 646288 Sub_Use_Service_Def.pdf
7/2/2018 10:18 AM 133619 SUD_Assessment.docx
8/13/2018 11:26 AM 133921 SUD_Assessment.dotx
7/2/2018 10:18 AM 84175 SUD_Brief_Engagement.docx
8/13/2018 11:26 AM 84219 SUD_Brief_Engagement.dotx
3/1/2019 5:50 PM 98226 SUD_CQRT_ Reg Compliance_Tool.dotx
4/15/2019 10:15 AM 773617 SUD_CQRT_ Reg Compliance_Tool.pdf
11/1/2018 10:15 AM 101871 SUD_CQRT_Authorization_Form.docx
3/1/2019 5:38 PM 65477 SUD_CQRT_Authorization_Form.dotx
4/15/2019 10:15 AM 523615 SUD_CQRT_Authorization_Form.pdf
8/21/2018 10:29 AM 15358 SUD_CQRT_Required_Documents.docx
8/13/2018 11:31 AM 44962 SUD_Drug_Test.dotx
6/25/2018 8:50 AM 92100 SUD_ROI_FORM.docx
6/25/2018 8:50 AM 93511 SUD_ROI_Form_Emergency_Contact.docx
8/13/2018 11:31 AM 107610 SUD_Treatment_Plan_Revised.dotx
6/26/2018 12:32 PM 101849 Tx Plan.docx
7/2/2018 10:33 AM 102905 Tx_Plan.docx
8/4/2017 8:28 AM 512385 TxPlan.pdf