Get Careconnection Form For Core - Aps Healthcare

Filling out the CareConnection Form For Core - APS Healthcare online is a straightforward process if you follow the necessary guidelines. This form is essential for capturing valuable information about individuals seeking behavioral health services.

Follow the steps to complete the CareConnection Form effectively

1. Click the ‘Get Form’ button to obtain the form and open it in an editor.
2. Begin by filling out the consumer demographic information. Enter the consumer's name and ID in the designated fields, as well as the request creator's name and clinician's details, including their phone number.
3. Next, address the request information section by indicating whether this is a retrospective authorization request. Select 'Yes' or 'No' accordingly.
4. In the consumer information section, provide the consumer's Medicaid number, completion date, and case status. Ensure to fill in the consumer's first and last name, city, state, mailing address, date of birth, and social security number accurately.
5. Complete the consumer's county of residence and marital status fields. Identify the referral source by selecting the appropriate option from the list.
6. For further clarity, specify the consumer's gender and participation status, choosing from the provided options.
7. For BHHF eligibility, fill in financial and household information such as gross monthly income and the number of household dependents.
8. Move on to the clinical information section. Indicate the disability group and document any diagnoses required. Fill out Axis I and Axis II information as relevant.
9. Outline the treatment plan summary by identifying the primary problem area to be addressed. Write a concise summary that encapsulates the treatment focus.
10. Finish by indicating the treatment plan type and status, selecting answers that correspond to the current situation.
11. Once all fields have been completed, users will have the option to save changes, download, print, or share the form.

Start filling out the CareConnection Form For Core - APS Healthcare online to ensure a smooth application process.