Provider Forms and References

Quick Reference Guides

• UnitedHealthcare Community Plan of New Jersey Quick Reference Guide
• Home and Community Based Services (HCBS) Quick Reference Guide
  
• Behavioral Health Quick Reference Guide
• Dental Quick Reference Guide

Reference Guides

• Doula: Submitting claims and member eligibility
• Family Guide to Autism Services - Chinese
  
• Family Guide to Autism Services - English
• Family Guide to Autism Services - Hindu
• Family Guide to Autism Services - Portuguese
• Family Guide to Autism Services - Spanish
• Family Guide to Autism Services - Tadjik
• Lead Screening Quick Reference Guide
• Leading the Way on Lead
• National Drug Codes Requirement for Claims Submission
• UnitedHealthcare Community Plan of New Jersey Appointment Availability and After-hours Standards
  
• Verifying Benefits and Billing Guidelines for New Jersey Network Health Care Providers
  

Provider Forms

• Critical Incident Reporting Form
• DOBI Claims Appeal Form
  
• Entity Disclosure of Ownership and Control Interest Form - Online Version
• Health Care Professional — Special Needs Survey Form
• Hysterectomy and Sterilization Procedures and Consent Forms
• Individual Disclosure of Ownership and Control Interest Form - Online Version
  
• Long-term Care Prior Authorization Fax Request Form
• Medication-Assisted Treatment (MAT) and Office Based Assisted Treatment (OBAT) Questionnaire
• Prior Authorization Forms
  
• Provider Disclosure of Ownership and Control Interest Statement form FAQ
• Synagis® Respiratory Syncytial Virus RSV Enrollment Form
  
• Specialist Referral Form
• Verbal risk assessment for lead toxicity