Materials
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- Doula services (PDF) - For more information visit: https://www.state.nj.us/humanservices/dmahs/info/doula.html or click here (PDF)
- Doula application form (PDF)
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Shared decision-making aids are communication tools used as a way for providers and patients to make informed health care decisions based on what is important to the patient. They do not replace physician guidance but are intended to help complement the discussions between patients and physicians on treatment decisions.
Below are evidence-based aids that provide information about treatment options, lifestyle changes, and outcomes.
- American Heart Association | Health Topics
- Diabetes | American Heart Association
- Flu Prevention | American Heart Association
- Heart Facts | American Heart Association
- Mayo Clinic | Care that fits
- Statin Choice | Mayo Clinic
- Depression Medication Choice | Mayo Clinic
- Cardiovascular Primary Prevention Choice | Mayo Clinic
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Contact Us
Providers who are interested in joining ABHNJ Network for Community Based Palliative Care should reach out the ABHNJ Network Team at NJMedicaidNetworkContracting@AETNA.com
In your email, please include a letter of intent with the information outlined below.
Group Name
Group NPI
Group TIN
Service address ( including county)
Provider Name(s)
Individual NPI
Specialty
The Contract Manager that handles the County in which you are located will contact you with the documents required to initiate the contracting/credentialing process.
Forms
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- Sublocade Enrollment Form (PDF)
- Primary care physician (PCP) re-assignment request form (PDF)
- Prior authorization request form (includes managed long-term services and supports (MLTSS) custodial requests) (PDF)
- Behavioral Health Prior Authorization Form (PDF)
- Prior authorization request form for medical equipment/supplies (PDF)
- Provider spot check questionnaire (PDF)
- Medical day care/personal care assistant service authorization request form (PDF)
- Personal care assistant (PCA) nursing assessment tool (PDF)
- Hysterectomy receipt of info form (PDF)
- Managed long- term services and supports (MLTSS) critical incident reporting form (PDF)
- Critical Incident Training Attestation Form (PDF)
- Sterilization consent form (PDF)
- Women, Infants and Children (WIC) health care referral form (PDF)
- Universal credentialing application (PDF)
- Disclosure of ownership (PDF)
- Program Eligibility Screening Tool (PDF)
- Comprehensive Medical Assessment Tool (CMAT) (PDF)
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Housing Supports Provider Credentialing Application Form (PDF)
Non-Traditional Provider Credentialing Application (PDF)
Housing Stabilization Plan — English (PDF) Spanish (PDF)
Initial Assessment Tool — English (PDF) Spanish (PDF)
Level of Need Assessment Tool — English (PDF) Spanish (PDF)
Helpful websites
Provider network files
These links provides access to our Aetna Better Health of New Jersey provider directory CSV files which can be downloaded by third parties and used to review data.
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