Provider Letters

Intro Letters – Community

• Support-Plan-Summary-Letter-Intro-to-Primary-Care-Provider 9-19-2025
• UTR Refusal Support Plan Summary – Intro to Primary Care Provider 4-1-2023
• Intro Letter to Other Waiver CM 3-23-2020

Intro Letter – Nursing Home

• NH-ICF Post Visit Summary Letter-Intro to Primary Care Provider 2-24-2023

EW Provider Signature cover letter:

• Provider Signature Cover Letter 5-23-2025

Care Coordinator changes only:

• Change in CC – Intro to Primary Care Provider 2-24-2023

Optional letter to send to provider for release of PHI:

• Provider Release Letter SB, MSC+ 091318