Forms for Mental Health Providers | Interface Behavioral Health

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For more information or a customized quote please contact us at:2424 Wilcrest Dr. | Suite 230 | Houston, TX 77042
Toll Free: (800) 324-4327

Changes to CPT Codes for 2013	Click Here
Changes to CPT Codes for 2013 FAQ	Click Here

Application- Individual Provider	Click Here
Application-Facility	Click Here
Refer your Behavioral Health Professional	Click Here
General Release of Information	Click Here
Provider Demographic Data Change Form	Click Here
E-Counseling Attestation Form	Click Here
W-9	Click Here

Introduction	Click Here
Pre-certification – Authorization of Treatment	Click Here
Adverse Determination	Click Here
Other Services	Click Here
Billing Procedures	Click Here
EAP Authorization Billing Form Sample	Click Here
Clinical Feedback Form	Click Here

Forms