Manuals and forms
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Manuals and forms
Manuals and guides
Downloadable forms
- Behavioral Health Prior Auth Form
- Dell Children’s Health Plan Prior Authorization Form
- Disease Management Referral Form
- Provider payment disputes—file disputes through the provider portal.
- Specialist as Primary Care Provider Request Form
- Texas Health Steps Provider Outreach Referral Form
- Texas Standard Prior Authorization Request Form for Health Care Services
- Texas Standard Prior Authorization Request Form for Prescription Drug Benefits
Behavioral health
- Behavioral Health Initial Review Form for Inpatient, Residential Treatment Center, Partial Hospital Program and Intensive Outpatient Program
- Behavioral Health Concurrent Review Form for Inpatient, Residential Treatment Center, Partial Hospital Program and Intensive Outpatient Program
- TRR UM Guidelines – Adult Mental Health Services
- TRR UM Guidelines – Child Adolescent Services
- Claims for Telephone BH Services
- Behavioral Health Discharge Assistance
- All other Behavioral Health Assistance
- Behavioral Health Provider Search
Updating provider information with Dell Children's Health Plan
- If you are an already contracted group but need to add a new provider, you can easily fill out the new Ascension Credentials Verification Services ARF Form. If you have any questions about this new process, please refer to the Ascension Credentials Verification Services (ACVS) FAQ document.
- If you need to make any changes to a provider’s address, phone number, group affiliation or other updates, please fill out our Adds, Changes, and Terms Spreadsheet and email it to our Provider Relations inbox at shpproviderservices@seton.org.
