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Aetna US Healthcare.QFF

Anthem BCBS - Behavioral Health - Connecticut - 10/8/04

Anthem Blue Cross.QFF

Anthem Behavioral Health - OTR - Virginia - 10/8/04

Behavioral Health Connecticut.QFF

Behavioral Health Connectuicut - OTR - 10/8/04

Behavioral Health CT.QFF

Blue Cross_SCarolina.QFF

Blue Cross Utica.QFF

Blue Cross of California ITP.QFF - San Diego, CA

Blue Cross Blue Shield of Florida FEP Outpatient Assessment 10/08/04

Blue Cross of California Review.QFF - San Diego, CA

Blue Cross Blue Shield of Massachusett - Benefits Review 10/8/04

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Charter Behavioral Health of PA.QFF

Clarendon Kids CHIP - Mental Health Treatment Request 10/08/04

Choice Behavioral Care.QFF

Choice Behavioral Health OTR.QFF

Cigna Chesapeake Regional Care Center.QFF

Cigna Summary Update Request Form.QFF

CNR Health.QFF

Colorado Health Network.QFF

Companion Benefit Alternatives.QFF

Companion Benefit Alternatives - Network OP Treatment Report 10/08/04

CompCare.QFF

CBC Concurrent Treatment Review.QFF - Continuum Behavioral Care

Continuum Behavioral Health MSO.QFF

CorpHealth.QFF

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DMHAS Behavioral Health Program OTR.QFF - ValueOptions

EAP Consultants Inc.QFF

Foundation Health.QFF

Foundation Health CD Addendum.QFF

Foundation Health Child Addendum.QFF

GHI Value Behavioral Health.QFF

Greenspring Initial Plan.QFF

Greenspring Concurrent Plan.QFF

Harvard Pilgrim Treatment Reauthorization.QFF

HIP OTR99.QFF

HMC Inc.QFF

HMS CapitalCare.QFF

Human Affairs International.QFF

IBHA Treatment Plan.QFF

Integrated Behavioral Health OTR.QFF

Integrated Behavioral Health_Discharge.QFF

Island Behavioral Health Landscape.QFF

Island Behavioral Health Appeal.QFF

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Magellan Initial Treatment Plan.QFF

Magellan Medication Management.QFF

Magellan Behavioral Health Treatment Request.QFF

Magellan High Volume Fax Form.QFF

Magellan OP Medication OTR.QFF

Magellan Referral_Request for Extension.QFF

Magellan Request for Recertification.QFF - formerly HAI

Mainstay, Inc Behavioral Health Treatment Plan.QFF

MAMSI.QFF

MAMSI Revised Patient Evaluation and Treatment (PET).QFF

MBC EAP Case Closing.QFF

MBC Referral_Extension Request.QFF

MBC Summary.QFF

MBC Tricare.QFF

MCC.QFF

MDNY Behavioral Health Encounter Review.QFF

Mental Health Treatment Report.QFF

Merit Behavioral Care.QFF

Merit Outpatient Treatment Request.QFF

Minnesota Universal OP Form.QFF     11/01/2005  REQUIRES QUICDOC V5.0.13 SP10 or later

MVP Health Plan.QFF

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NY Workers Comp_MD Report.QFF

NY Workers CompA.QFF

Options Medication Management.QFF

Options Mental Health Military.QFF

Options Mental Health.QFF

Oxford Mental Health.QFF

Plan 21 Progress Report.QFF

Plan 21 Closing.QFF

PMI OTR.QFF

PMI Outpatient Treatment Report.QFF

PPC OTR.QFF

Preferred Mental Health Management.QFF

Premier Behavioral Systems.QFF

ProBehavioral Health.QFF

Psych Management Initial.QFF

Psych Management OTR.QFF

PsychCare Network Psychiatrist.QFF

QualChoice MH Therapy Request.QFF

Rocky Mtn First Plan.QFF

Rocky Mtn Second Plan.QFF

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Sheppard-Pratt OTR.QFF

Sombha.QFF

Spectera.QFF

StateofMDUniformTreatment Plan.QFF - Maryland Uniform Treatment Plan

Tufts Treatment Authorization Request.QFF

Tufts Health Plan.QFF - Psychiatric/Substance Abuse OTR - New

Tricare MHN.QFF - Version 8/2000

Tricare MHN CD Addendum.QFF

Tricare MHN Child/Adolescent Addendum.QFF

UBH Claim Form.QFF

UBH Managed EAP Claim.QFF

UBH Standard EAP Claim.QFF

United Behavioral Health Closing.QFF

United Behavioral Health Initial.QFF

United Behavioral Health Progress.QFF

United Behavioral Systems.QFF - aka United Behavioral Health

UBS Treatment Plan.QFF - aka United Behavioral Health

UPMC OP Notification and Brief Assessment.QFF - Western Behavioral Health

UPMC Risk Profile.QFF - Western Behavioral Health

UT Southwestern Initial Clinical Summary.QFF

UT Southwestern Treatment Progress Report.QFF

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Value Behavioral Health Landscape.QFF

ValueOptions OTR.QFF

ValueOptions Treatment Report.QFF - * Improved Version

Value Options/Harvard Pilgrim Health Care - Comprehensive Treatment Report 10/08/04

Value Options/Harvard Pilgrim Health Care - Brief OP Treatment Report 10/08/04

Wash Co Behavioral Health.QFF

Wausau CD-UR Form.QFF

WellPoint Behavioral Health.QFF - Initial Treatment Plan

Western Behavioral Healthcare Network.QFF - Outpatient Treatment Plan

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last updated 11/01/2005

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