Documents
- General Documentation
- Forms
- Advanced Directive Attestation
- Application for Services and Consent (adult)
- Application for Services and Consent (youth)
- Application for Services and Consent - Spanish (adult)
- Application for Services and Consent - Spanish (youth)
- Board of Directors Conflict of Interest Annual Disclosure
- Business Associate Addendum
- Clinician Attestation
- CLIP Voluntary Application Form
- Computer and Information Security Agreement
- Confidentiality & Security Agreement (HIPAA)
- Data Entry Form - Demographics
- Data Entry Form - Periodics
- GCBH Data Certification Form
- GCBH Decertification Form
- Notice of Action
- Notice of Determination
- Privacy Notice
- Privacy Notice (Spanish)
- Single Bed Certification Worksheet
- DSHS Current Data Dictionary
- GCBH Data Dictionary and Trading Partner Agreement
- GCBH Error and Warning List - Alphabetical
- GCBH Error and Warning List - Transaction
- GCBH Section 1 Provider View (with changes marked)
- GCBH Section 2 Validation Code Tables (with changes marked)
- GCBH Section 3 Glossary Of Terms (with changes marked)
- GCBH Trading Partner Agreement (with changes marked)
- GCBH Trading Partner Agreement - 837I
- Upcoming GCBH Data Dictionary and Trading Partner Agreement - Effective as of May 8, 2010, or with the implementation of ProviderOne, whichever arrives first
- GCBH Data Dictionary 2.1 Sec 1
- GCBH Data Dictionary 2.1 Sec 1 (with changes marked)
- GCBH Data Dictionary 2.1 Sec 2
- GCBH Data Dictionary 2.1 Sec 2 (with changes marked)
- GCBH Data Dictionary 2.1 Sec 3
- GCBH Data Dictionary 2.1 Sec 3 (with changes marked)
- GCBH Trading Partner Agreement - 837P
- GCBH Trading Partner Agreement - 837P (with changes marked)
- GCBH Trading Partner Agreement - 837I
- GCBH Trading Partner Agreement - 837I (with changes marked)
Phone: 509.735.8681 or 800.795.9296