To help you support your HealthPlus patients, you can download and print most forms and documents you will need. If you cannot find a form you are looking for, contact your HealthPlus Provider Educator for assistance.

Claims Adjustment (pdf: 58k)
Other Insurance Information Inquiry Form (pdf: 56k)
Member Discharge / Termination Request Form (pdf: 7k)
Provider Records Change Form (pdf: 33k)
HealthPlus requires requested provider records changes be submitted in writing using this form. HealthySolution Treatment Plan Form
Please note that only HealthySolutions members are required to complete a Treatment Plan form. Medical Record Forms
Medical Record Forms Provider Login Access Form (pdf: 11k)
If you have not yet registered for the secure Provider Online Service Center and would like to take advantage of its available services . . . Provider Manual
The Provider Manual instructions on how to utilize our services and pertinent policy and resource information! Provider Service Center Manual (pdf: 3651k)
A guide to the Provider Service Center, where you can check member eligibility, claim status, referral status and more...

Referral Submission Guide (pdf: 1003k)
A guide for referral submission via the Provider Service Center. Care Plan Form
DME P&O Request Form (pdf: 18k)
HealthPlus Preliminary Report of Patient Consultation Form (pdf: 33k)
Michigan HealthCare Referral Form (pdf: 236k)
Patient Narcotic Contract (pdf: 63k)
Referral Fax Sheet (pdf: 17k)
Special Office Procedures Request Form (doc: 42k)
Tobacco & Weight Program Request Form (pdf: 88k)