bhcsproviders.acgov.org - /providers/QA/NOABD/NOABD Letters and Attachments/NOABD Letter Translations/Translated Templates_English/

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 5/31/2023  7:38 AM       147581 1 Attachment A- Denial.docx
 5/31/2023  7:38 AM       101888 2 Attachment B- Payment Denial.doc
 5/31/2023  7:39 AM       105984 3 Attachment C- Delivery System.doc
 5/31/2023  7:39 AM       106496 4 Attachment D- Modification.doc
 5/31/2023  7:39 AM       101376 5 Attachment E- Termination.doc
 5/31/2023  7:40 AM       103424 6 Attachment F- Timely Access.doc
 5/31/2023  7:40 AM       172544 7 Attachment G- Financial Liability.doc
 5/31/2023  7:40 AM       143360 8 Attachment H- Authorization Delay.doc
 5/31/2023  7:41 AM       131584 9 Attachment I- Grievance and Appeal.doc
 9/15/2025  2:02 PM        <dir> Archive - Translated Templates_English
 9/15/2025 12:56 PM        69974 Attachment_A-Denial-Notice.docx
 7/29/2025 12:24 PM        68893 Attachment_A-Denial.docx
 3/14/2025 11:12 AM        97003 Attachment_A-Denial.pdf
 9/15/2025 12:56 PM        65383 Attachment_B-Payment_Denial.docx
 3/14/2025 11:12 AM       118606 Attachment_B-Payment_Denial.pdf
 9/15/2025 12:56 PM        65437 Attachment_C-Delivery_System.docx
 3/14/2025 11:12 AM       139406 Attachment_C-Delivery_System.pdf
 9/15/2025 12:56 PM        65595 Attachment_D-Modification.docx
 3/14/2025 11:13 AM       154047 Attachment_D-Modification.pdf
 9/15/2025 12:56 PM        64915 Attachment_E-Termination.docx
 3/14/2025 11:13 AM       148441 Attachment_E-Termination.pdf
 9/15/2025 12:56 PM        61660 Attachment_F-Financial_Liability.docx
 3/14/2025 11:13 AM       206168 Attachment_F-Financial_Liability.pdf
 9/15/2025 12:56 PM        62074 Attachment_G-Timely_Access.docx
 3/14/2025 11:14 AM       165447 Attachment_G-Timely_Access.pdf
 9/15/2025 12:56 PM        64203 Attachment_H-Authorization_Delay.docx
 3/14/2025 11:14 AM       153655 Attachment_H-Authorization_Delay.pdf
 9/15/2025 12:57 PM        62198 Attachment_I-Grievance_and_Appeal.docx
 3/14/2025 11:14 AM       153201 Attachment_I-Grievance_and_Appeal.pdf
 7/29/2025  1:29 PM        62914 Behavioral Health Memo Template.dotx
 7/29/2025 12:51 PM       109913 NOABD_English_Coversheet_Template.pdf