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Services or Offerings?
Add New User - Adult HH Only
  1. Services
  2. Accounts and Access
Add new user request form for all users in the ADULT Health Home
Billing Questionnaire Void (HML or CBQ)
  1. Services
  2. Billing (CBQ's/HML's)
Request to void a finalized billing questionnaire (HML or CBQ)
CIN Change
  1. Services
  2. Netsmart Chart Adjustment/Correction
Please use this form if your member requires a CIN Change.
Client Name Change Request
  1. Services
  2. Netsmart Chart Adjustment/Correction
This form can be used to request a client name change request.
Disable User
  1. Services
  2. Accounts and Access
Disable access for user
General Questions
  1. Services
  2. General Questions
Any question(s) that does not fall under one of the services already listed not chart based
HHUNY - Adult Community Referral Form
  1. Services
  2. Referrals
A referral for Medicaid members to receive health home care management services through HHUNY affiliated health homes
HHUNY - Adult Self Referral Form
  1. Services
  2. Referrals
A referral for Medicaid members to receive health home care management services through HHUNY affiliated health homes
Location Policy Exception Request
  1. Services
  2. Accounts and Access
Request access to HHUNY resources outside of New York State for a CMA user
Member Complaint/Issue Form
  1. Services
  2. Member Complaint/Issue
Used to report any member complaint/issue to HHUNY Compliance
MFA Reset
  1. Services
  2. Accounts and Access
Reset MFA (including Okta verify) for Netsmart and/or HHUNY Okta (Access to: HHUNY Help Desk, HHUNY Portal, Tableau, & ShareFile)
Miscellaneous Assessment Void
  1. Services
  2. Netsmart Chart Adjustment/Correction
Form for voiding any assessment other than HMLs or CBQs (e.g. Crisis Plans, Eligibility Assessments).
*This form should NOT be used to request HML or CBQ voids!
Miscellaneous Training Question
  1. Services
  2. Netsmart/Training Questions
Miscellaneous questions regarding training
Missing Data In Netsmart
  1. Services
  2. Netsmart Chart Adjustment/Correction
Submit a request to restore missing data (e.g. notes, HMLs/CBQs, other assessments) into a chart.
Netsmart Training Question
  1. Services
  2. Netsmart/Training Questions
Training questions on how to use Netsmart system