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Add new user request form for all users in the HHUNY Adult Health Home

Request to void a finalized billing questionnaire (HML)

Please use this form if your member requires a CIN Change.

This form can be used to request a client name change request.

Disable access for user

Any question(s) that does not fall under one of the services already listed not chart based

A referral for Medicaid members to receive health home care management services through HHUNY affiliated health homes

A referral for Medicaid members to receive health home care management services through HHUNY affiliated health homes

Request access to HHUNY resources outside of New York State for a CMA user

Used to report any member complaint/issue to HHUNY Compliance

Reset MFA (including Okta verify) for Netsmart and/or HHUNY Okta (Access to: HHUNY Help Desk, HHUNY Portal, Tableau, & ShareFile)

Form for voiding any assessment other than HMLs (e.g. Crisis Plans, Eligibility Assessments).
*This form should NOT be used to request HML voids!

Miscellaneous questions regarding training

Submit a request to restore missing data (e.g. notes, HMLs, other assessments) into a chart.

Training questions on how to use Netsmart system