Provider Forms

NEW!  CLINICAL DATA COVERSHEET

With the advent of our new outpatient authorization process, providers are asked to use this coversheet when transmitting clinical information to American Behavioral. 

EVALUATION SURVEYS

Employee Assistance Program (EAP) providers are increasingly asked by their current client companies and by prospectiveclients to provide data supporting the effectiveness of their programs. Client companies want to know what return on investment they may expect from an EAP service.

Some of the benefits of an effective EAP are: increased employee productivity, decreased employee absences, more engaged employees, improved organizational morale, decreased turnover of employees, and reduced overall healthcare claim costs.

American Behavioral is committed to providing our client companies with a positive return on their investment. We need your help as American Behavioral providers to document and measure actual outcomes of our services. At the initial evaluation session, please ask each client to complete a brief survey to measure pre-treatment status, and upon completion of EAP services, ask the client to complete the Post-Survey. Then return both the Initial Evaluation Survey and the Post-Survey along with your Case Closure form and your invoice for EAP services. Both surveys can be downloaded from the American Behavioral website.

Thank you for working with American Behavioral to validate the value of the services we provide.

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DIRECT DEPOSIT IS NOW AVAILABLE!!!

Download the Direct Deposit form, attach a voided check and mail to our credentialing department.  Please note that you must have a valid E-mail address to be eligible for Direct Deposit Services.

We will alert you when the initial set up is complete and notify you of your password to check status and retrieve DRA's on our secure FTP site.

All documents are in Adobe Acrobat Portable Document File (PDF) format. If you are unable to read these forms, go to Adobe to download the free Adobe Acrobat Reader.