Provider materials and forms

• Provider manual (PDF)
• Provider quick reference guide (PDF)
• Prior authorization (PA) list (PDF)
• Reimbursement policy statement (PDF)
• Healthcare Effectiveness Data and Information Set (HEDIS®) documentation tips (PDF)
• Aetna Betther Health of Louisiana Care Advocates and Peer Support Specialist (PDF)

• Behavioral health provider manual (PDF)
• Behavioral health fee schedule (PDF)
• Behavior health training
• American Academy of Pediatrics Louisiana Chapter ADHD Toolkit
• Provider Resources: ADHD Care and Treatment (PDF)

Shared decision-making aids are communication tools used as a way for providers and patients to make informed health care decisions based on what is important to the patient.   They do not replace physician guidance but are intended to help complement the discussions between patients and physicians on treatment decisions.   

Below are evidence-based aids that provide information about treatment options, lifestyle changes, and outcomes.
 

• American Heart Association | Health Topics
• Diabetes | American Heart Association
• Flu Prevention | American Heart Association
• Heart Facts | American Heart Association
• Mayo Clinic | Care that fits
• Statin Choice | Mayo Clinic
• Depression Medication Choice | Mayo Clinic
• Cardiovascular Primary Prevention Choice | Mayo Clinic
• Think Measles (PDF)

• Universal Prescription Prior Authorization Request Form (PDF)
• Provider Advisory Council Form
• Care Management Referral Form
• Health Equity Provider Attestation Form (PDF)
• Physical Health Prior Authorization Request Form (PDF)
• Behavioral Health Prior Authorization Request Form (PDF)
• Primary care physician (PCP) change request form (PDF)
• Provider info change form (PDF)
• Provider and subcontractor disclosure of ownership and controlling interest worksheet (PDF)
• Provider claim resubmission and dispute form (PDF)
• Independent review provider reconsideration request form (PDF)
• Personal appeal representative form (PDF)
• Data long form (PDF)
• Notification of pregnancy form (PDF)
• Informed consent for abortion form (PDF)
• Sterilization consent form (PDF)
• Hysterectomy receipt of info form (PDF)
• Adverse incident reporting form (PDF) and instructions for the form (PDF) 

• CPST/PSR form (PDF)
• Mental health rehabilitation member choice form (PDF)
• Hamilton rating scale for depression (PDF)
• Informed consent for treatment form (PDF)
• Initial evaluation template (PDF)
• Adult behavioral health assessment form (PDF)
• Adolescent suicide assessment protocol (PDF)
• Abnormal involuntary movement scale (AIMS) (PDF)
• Patient health questionnaire (PDF)
• Patient health care preferences questionnaire (PDF)
• Patient safety plan template (PDF)
• Progress note (SIRP format) form (PDF)
• Suicide behaviors questionnaire-revised (SBQ-R) (PDF)
• Suicide risk assessment form (PDF)
• Treatment plan template (PDF)

• Louisiana Board of Pharmacy Prescription Monitoring Program (PMP)
• Louisiana Center for Evidence to Practice
  
  • Online learning
  • Telehealth support for behavioral health
• Agency for Healthcare Research and Quality
• Medical Home Improvement
• Milliman Care Guidelines (MCG)
• Case Management Society of America (CMSA)
• National Committee for Quality Assurance (NCQA) health plan accreditation
• U.S. Preventive Services Prevention TaskForce tools for primary care clinicians