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Get and Sign Substance Abuse Discharge Note Providers Select Health of  Form

Get and Sign Substance Abuse Discharge Note Providers Select Health of Form

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Problem potential Dimension 6 recovery environment Was member transitioned to lower level of care Yes No If yes please provide specifics below i.e. level of care expected start date and expected duration of treatment If no please explain Discharge medications Include all medications including medical. Please provide dose frequency and condition for which medication is prescribed. Are these medications on the formulary If the answer to the above is no has precertification been received Risk...
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