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Essentiality Certificate  Form

Essentiality Certificate Form

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Instructions and help about hbtu medical certificate format

greetings in this brief video we're gonna cover the steps for successfully completing the certificate of need or con specifically for PRTF services both in and out of the state of montana as a reminder the con is one step in the process for submitting authorization requests for PRTF services for a full listing of the requirements please reference the children's mental health bureau's Medicaid services provider manual which can be found at the link here most importantly please note all fields of this form must be completed not just the youth information section this is true when submitting for both PAs and CSRs next we do require all fields be completed for the youth in terms of both their demographic and current living information which may be your facility or dorms physical address this is followed by the facility name which is either the admitting or treating facility and the NPI number both admit and discharge dates should always be included and updated each

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