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    Lookup Category Clear Category
    Services or Offerings?
    Add New User
    1. Services
    2. Accounts and Access
    Add new user request form for all users in the HHUNY Adult Health Home
    Billing Questionnaire Void (HML)
    1. Services
    2. Billing (HML's)
    Request to void a finalized billing questionnaire (HML)
    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.
    Deactivate User
    1. Services
    2. Accounts and Access
    Deactivate 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 - 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 - 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 (e.g. Crisis Plans, Eligibility Assessments).
    *This form should NOT be used to request HML 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, other assessments) into a chart.
    Netsmart Reporting Tool
    1. Services
    2. Netsmart Chart Adjustment/Correction
    Request a new Netsmart report or report issue on existing Netsmart report