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EasyCare EasyCare Plus Total
Authorization for Release of Health Information Form (DOH 5032)
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Total
CDPAS Recertification – Physician Order Form

Total Members can have their home care service provided by a consumer directed personal care assistant through Consumer Directed Personal Assistance Services (CDPAS). The physician order form is required during the initial assessment and every 6 months during CDPAS recertification.

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Physician Order Form
EasyCare Plus Total EasyCare
Health Information Exchange Fact Sheet and Form
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Your Rights and Responsibilities
Total EasyCare Plus EasyCare
Information About Our Grievances and Appeals Process
Total EasyCare Plus EasyCare
Making Decisions About Your Health Care
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Total
Member Rights and Responsibilities upon Disenrollment
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Total EasyCare Plus EasyCare
Patient Self-Determination Policies
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EasyCare Plus Total EasyCare
Planning in Advance for Your Medical Treatment
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Prior Authorization Request Forms
EasyCare EasyCare Plus Total
Medicare Prior Authorization Requirements
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Medicare Prior Authorization Requirements
EasyCare Plus Total EasyCare
New York State Medicaid Prior Authorization Request Form for Prescriptions
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NYS Medicaid Prior Authorization Request Form