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Use Mass Collaborative form for BH level of care requests
July 22, 2019

This article is for all behavioral health providers, all physicians, and primary care providers

As part of its efforts to simplify administration for providers, the Massachusetts Collaborative creates standardized authorization forms and updates them as needed. To ensure that you always use the most up-to-date version of the Behavioral Health - Level of Care Request Form, we have separated our required Supplemental form from the Mass Collaborative’s form.

How to access the forms
To ensure that providers always use the most current version of the form, we have put a link to the Collaborative’s form and changed our form’s name to Behavioral Health – Level of Care Request Supplemental Form. Please be sure to submit both the Request Form and Supplemental Form.

Questions?
Please contact your Network Manager.

MPC_070319-2M-1

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