Required Activities (continued)
|
|
- Angelina Cunningham
- 5 years ago
- Views:
Transcription
1
2 DMAS-CMHRS Manual Services based upon incomplete, missing, or outdated (more than a year old or not reflective of the individuals current level of need) intakes/re-assessments and ISPs shall be denied reimbursement. - CMHRS Manual
3 CMHRS Manual (DMAS) Required Activities- The following services and activities must be provided: A comprehensive service specific provider assessment must be completed by a qualified mental health case manager to determine the need for services. The CM service specific provider assessment is part of the first month of CM service and requires no service authorization. Service specific provider assessment and planning services, to include developing an ISP (does not include performing medical and psychiatric assessment, but does include referral for such).
4 Required Activities (continued) This service specific provider assessment then serves as the basis for the ISP. The service provider must notify or document the attempts to notify the primary care provider or pediatrician of the individual s receipt of community mental health rehabilitative services, specifically mental health case management. The ISP must document the need for case management and be fully completed within 30 days of initiation of the service, and the case manager shall review the ISP every three months. The review will be due by the last day of the third month following the month in which the last review was completed. A grace period will be granted up to the last day of the fourth month following the month of the last review.
5 Required Activities (continued) Mandatory monthly case management contact, activity, or communication relevant to the ISP. Written plan development, review, or other written work is excluded. Linking the individual to needed services and supports specified in the ISP. Provide services in accordance with the ISP. Coordinating services and treatment planning with other agencies and providers. Enhancing community integration through increased opportunities for community access and involvement and creating opportunities to enhance community living skills to promote community adjustment. Making collateral contacts with significant others to promote implementation of the service plan and community adjustment.
6 Required Activities (continued) Monitoring service delivery as needed through contacts with service providers as well as periodic site visits and home visits. Education and counseling, which guide the individual and develop a supportive relationship that promotes the service plan. Counseling, in this context, is not psychological counseling, examination, or therapy. The case management counseling is defined as problemsolving activities designed to promote community adjustment and to enhance an individual s functional capacity in the community. These activities must be linked to the goals and objectives on the Case Management ISP.
7 Required Activities (continued) A face-to-face contact must be made at least once every 90-day period. The purpose of the face-to-face contact is for the case manager to observe the individual s condition, to verify that services which the case manager is monitoring are in fact being provided, to assess the individual s satisfaction with services, to determine any unmet needs, and to generally evaluate the member s status. Case Management services are intended to be an individualized client-specific activity between the case manager and the member. The ISP shall be updated at least annually.
8 Service Limitations (DMAS) Billing can be submitted for case management only for months in which direct or clientrelated contacts, activity, or communications occur. These activities must be documented in the clinical record. The provider should bill for the specific date of the face to face visit, or the date the monthly summary note has been documented, or a specific date service was provided.
9 Service Limitations (DMAS) Reimbursement shall be provided only for "active" case management clients, as defined. An active client for case management shall mean an individual for whom there is a plan of care in effect which requires regular direct or client related contacts or activity or communication with the client or families, significant others, service providers, and others including a minimum of one face-to-face client contact within a 90-day period.
10 Service Limitations (DMAS) Federal regulation 42CFR prohibits providers from using case management services to restrict access to other services. An individual cannot be compelled to receive case management if he or she is receiving another service, nor can an individual be required to receive another service if they are receiving case management.
11 Documentation Requirements A SSPI (service specific provider intake) shall be required prior to developing an Individual Services Plan (ISP) and shall be required as a reference point for the ISP during the entire duration of services. Services based upon incomplete, missing, or outdated (more than a year old or not reflective of the individual s current level of need) intakes/re- assessments and ISPs shall be denied reimbursement.
12 Documentation (DMAS) Case management records must include the individual s name, dates of service, name of the provider, nature of the services provided, achievement of stated goals, if the individual declined services, and a timeline for reevaluation of the plan. There must be documentation that notes all contacts made by the case manager related to the ISP and the individual s needs
13 Documentation The case manager must have monthly activity regarding the individual and a face-to-face contact with the individual at least once every 90 days. * If there was no monthly CM activity, there must be documentation explaining why not.
14 Documentation The provider shall determine who the primary care provider is and inform him or her of the individual's receipt of Case Management Services. The documentation shall include who was contacted, when the contact occurred, and what information was transmitted.
15 Documentation An individualized and individual specific ISP must be part of the record. The ISP must address the issues as documented in the SSPI. There must be documentation indicating that the individual was included in the development of the ISP and the ISP shall be signed by the individual. If the individual is a child, the ISP shall also be signed by the individual's parent/legal guardian. Documentation shall be provided if the individual, who is a child or an adult who lacks legal competency, is unable or unwilling to sign the ISP.
16 Documentation The ISP contains his treatment or training needs, his goals and measurable objectives to meet the identified needs, services to be provided with the recommended frequency to accomplish the measurable goals and objectives, the estimated timetable for achieving the goals and objectives, and an individualized discharge plan that describes transition to other appropriate services.
17 ISP Requirements Goals: Should reflect an individualized specific overview of the objectives and will address the larger presenting needs. Goals are longer term than objectives Objectives: Should demonstrate shorter term, measurable, achievable, action-oriented, strength based activities that the individual/family will engage in toward completion of the goal.
18 ISP Requirements Intervention/Strategies: Should define specific steps that the provider and individual will engage in toward the attainment/achievement of each objective. Interventions are developed based on the individual s specific strengths and needs (i.e. developmental level, level of functioning, academic/literacy ability, interests, etc.). Interventions should clearly reflect service coordination. purpose of the goals to be achieved within the authorized time period;
19 ISP Requirements Frequency: The ISPs must include the recommended service frequency needed to accomplish the goals and objectives that will meet the needs identified in the SSPI. The ISP must be reviewed, at a minimum, every 3 months to determine if the goals and objectives meet the needs of the individual. The ISP shall be updated annually and as the needs, goals and progress of the individual changes. Discharge Goal: All ISPs shall include an individualized discharge plan. Describe the discharge planning to summarize an estimated timetable to achieving the goals and objectives in the service plan, include discharge plans that are specific to need of the individual at the time the service needs are reviewed.
20 Documentation Service coordination between all health care service providers who are involved in the individual s care is required and must be documented in the ISP and Progress Notes. DMAS shall not reimburse for dates of services in which the progress notes are not individualized and case-specific. Duplicated progress notes shall not constitute the required case-specific individualized progress notes.
21 Documentation Individualized and case-specific progress notes are part of the minimum documentation requirements and shall convey the individual's status, staff interventions, and, as appropriate, the individual's progress, or lack of progress, toward goals and objectives in the ISP. Documentation shall be written, signed, and dated at the time the services are rendered or within one business day from the time the services were rendered.
22 12VAC Individual Services Plan (ISP) Requirements: If one of these elements are missing, the ISP will be considered incomplete and not meeting the reimbursement requirements. The ISP is a comprehensive and regularly updated document that integrates both physical and behavioral health, service coordination, and integrated care goals specific to the needs of the individual being treated and meeting the defined specific service requirements. The "Individual Service Plan" or "ISP" means a comprehensive and regularly updated treatment plan specific to the individual's unique treatment needs as identified in the clinical assessment. A comprehensive ISP is personcentered, includes all planned interventions, aligns with the member s identified needs, care coordination needs, is regularly updated as the member s needs and progress change, and shows progress throughout the course of treatment. The ISP contains, but is not limited to, the individual s treatment or training needs, the individual s goals and measurable objectives to meet the identified needs, services to be provided with the recommended frequency to accomplish the measurable goals and objectives, the estimated timetable for achieving the goals and objectives, and an individualized discharge plan that describes transition to other appropriate services. The individual shall be included in the development of the ISP and the ISP shall be signed by the individual. If the individual is a minor child, the ISP shall also be signed by the individual's parent/legal guardian. Documentation shall be provided if the individual, who is a minor child or an adult who lacks legal capacity, is unable or unwilling to sign the ISP
23 12VAC ISP requirements A. The comprehensive ISP shall be based on the individual's needs, strengths, abilities, personal preferences, goals, and natural supports identified in the assessment. The ISP shall include: Relevant and attainable goals, measurable objectives, and specific strategies for addressing each need; Services and supports and frequency of services required to accomplish the goals including relevant psychological, mental health, substance abuse, behavioral, medical, rehabilitation, training, and nursing needs and supports; The role of the individual and others in implementing the service plan; A communication plan for individuals with communication barriers, including language barriers; A behavioral support or treatment plan, if applicable; A safety plan that addresses identified risks to the individual or to others, including a fall risk plan; A crisis or relapse plan, if applicable; Target dates for accomplishment of goals and objectives; Identification of employees or contractors responsible for coordination and integration of services, including employees of other agencies; and Recovery plans, if applicable.
24 DBHDS Regulation 880.C - Entries in record shall be current, dated and authenticated by staff making entries. 660.B - The ISP shall be signed and dated at a minimum by the person responsible for implementing the plan and the individual receiving services or the authorized representative. If the signature of the individual receiving services or the authorized representative cannot be obtained, the provider shall document his attempt to obtain the necessary signature and the reason why he was unable to obtain it.
25 DBHDS definitions: "Person-centered" means focusing on the needs and preferences of the individual; empowering and supporting the individual in defining the direction for his life; and promoting self-determination, community involvement, and recovery. "Case management service" means services that can include assistance to individuals and their family members in assessing needed services that are responsive to the person's individual needs. Case management services include: identifying potential users of the service; assessing needs and planning services; linking the individual to services and supports; assisting the individual directly to locate, develop, or obtain needed services and resources; coordinating services with other providers; enhancing community integration; making collateral contacts; monitoring service delivery; discharge planning; and advocating for individuals in response to their changing needs. "Case management service" does not include maintaining service waiting lists or periodically contacting or tracking individuals to determine potential service needs.
26 DBHDS Definitions "Serious incident" means any incident or injury resulting in bodily damage, harm, or loss that requires medical attention by a licensed physician, doctor of osteopathic medicine, physician assistant, or nurse practitioner while the individual is supervised by or involved in services, such as attempted suicides, medication overdoses, or reactions from medications administered or prescribed by the service. "Corrective action plan" (CAP) means the provider's pledged corrective action in response to cited areas of noncompliance documented by the regulatory authority. A corrective action plan must be completed within a specified time.
27 DBHDS Definitions "Individualized services plan" or "ISP" means a comprehensive and regularly updated written plan that describes the individual's needs, the measurable goals and objectives to address those needs, and strategies to reach the individual's goals. An ISP is personcentered, empowers the individual, and is designed to meet the needs and preferences of the individual. The ISP is developed through a partnership between the individual and the provider and includes an individual's treatment plan, habilitation plan, person-centered plan, or plan of care, which are all considered individualized service plans.
28 D19 required forms Screening Form (must be kept in active chart- do not purge) Admission Assessment/Service Specific Provider Intake. Do not purge original. Program Orientation checklist- do not purge Face Sheet Human Rights Consent to Services Receipt of Notice of Privacy Authorization/Releases of Confidential Information Fall Risk Assessment Release of Liability of Transportation
29 D19 Forms- continued Individualized Service Plan Quarterly Progress Reviews Consumer Responsibilities Medical Consultation/Contact with Primary Care Physician Financial documents Referral forms if applicable Transfer Summary if applicable Discharge Summary if applicable
30 Resources This presentation is a brief overview of the requirements. Refer to D19 program policies and procedures Refer to DMAS- CMHRS Manual (Community Mental Health Rehabilitative Services) /ProviderManual Refer to DBHDS CHAPTER 105 RULES AND REGULATIONS FOR LICENSING PROVIDERS BY THE DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICEShttp:// 12vac35-105dec2011.pdf
Psychosocial Rehabilitation (PSR) H2017. Presented by the Clinical and Quality Teams September 2016
Psychosocial Rehabilitation (PSR) H2017 Presented by the Clinical and Quality Teams After today s training you will be able to: Determine Department of Medical Assistance (DMAS) Medical Necessity Criteria
More informationResidential Treatment Services Manual 6/30/2017. Utilization Review and Control UTILIZATION REVIEW AND CONTROL CHAPTER VI. Page. Chapter.
1 UTILIZATION REEW AND CONTROL CHAPTER 2 CHAPTER TABLE OF CONTENTS PAGE Financial Review and Verification... 3 Utilization Review (UR) - General Requirements... 3 Appeals... 4 Documentation Requirements
More informationTHE ADDICTION AND RECOVERY TREATMENT SERVICES PROGRAM (ARTS) PROVIDER MANUAL
THE ADDICTION AND RECOVERY TREATMENT SERVICES PROGRAM (ARTS) PROVIDER MANUAL SUPPLEMENTAL INFORMATION This Supplement to the Optima Health Provider Manual is available for Providers who provide services
More informationCovered Services and Limitations 07/31/2015 CHAPTER IV COVERED SERVICES AND LIMITATIONS. Manual Title Community Mental Health Rehabilitative Services
Community Mental Health Rehabilitative Services Revision Date CHAPTER COVERED SERVICES AND LIMITATIONS Revision Date i CHAPTER TABLE OF CONTENTS PAGE BEHAVIORAL HEALTH SERVICES ADMINISTRATOR 1 MEDALLION
More information907 KAR 1:044. Coverage provisions and requirements regarding community mental health center behavioral health services.
907 KAR 1:044. Coverage provisions and requirements regarding community mental health center behavioral health services. RELATES TO: KRS 194A.060, 205.520(3), 205.8451(9), 422.317, 434.840-434.860, 42
More information907 KAR 15:080. Coverage provisions and requirements regarding outpatient chemical dependency treatment center services.
907 KAR 15:080. Coverage provisions and requirements regarding outpatient chemical dependency treatment center services. RELATES TO: KRS 205.520, 42 U.S.C. 1396a(a)(10)(B), 1396a(a)(23) STATUTORY AUTHORITY:
More informationA SUMMARY OF MEDICAID REQUIREMENTS AND RELATED COA STANDARDS
A SUMMARY OF MEDICAID REQUIREMENTS AND RELATED COA STANDARDS This tool is intended to provide a broad overview of common Medicaid (MA) requirements in relation to COA s Standards. While there are specific
More informationRegulations. The regulations which require and govern reports to DBHDS which could be reported in the CHRIS system are:
CHRIS Reporting: There are a number of issues and concerns which have been raised about the requirements of the CHRIS reporting system. We are not going to attempt to address the technical issues with
More informationProvider Alert April, 2010 Common Audit Findings
Provider Alert April, 2010 Common Audit Findings OMHC Audit Item#/Description 2. If the consumer is a child for whom courts have adjudicated their legal status or an adult with a legal guardian, are there
More informationTreatment Foster Care-Case Management (TFC-CM) TFC Overview provided by Clinical and Quality teams Quarter
Treatment Foster Care-Case Management (TFC-CM) TFC Overview provided by Clinical and Quality teams Quarter 1 2016 After today s training you will be able to: Determine DMAS Medical Necessity Criteria (MNC)
More informationMIND MATTERS PSYCHIATRYMD PATIENT INTAKE FORMS LONG PRAIRIE ROAD SUITE 100 FLOWER MOUND, TX 75022
MIND MATTERS PSYCHIATRYMD PATIENT INTAKE FORMS 2017 2620 LONG PRAIRIE ROAD SUITE 100 FLOWER MOUND, TX 75022 Whose # is this? Whose # is this? 2 2 3 4 fa 5 6 X 7 8 Mind Matters PsychiatryMD Patient Responsibilities
More informationSTAR+PLUS through UnitedHealthcare Community Plan
STAR+PLUS through UnitedHealthcare Community Plan Optum 06012014 Who We Are United Behavioral Health (UBH) was created February 2, 1997, through a merger of U.S. Behavioral Health, Inc. (USBH) and United
More informationComprehensive Community Services (CCS) File Review Checklist Comprehensive
This is a sample form developed by the "CCS Statewide QA/QI Work Group", and is available to CCS sites as a sample for consideration of use, modification, and customization. There is no implicit or explicit
More informationCMHC Conditions of Participation
CMHC Conditions of Participation Mary Rossi-Coajou Center for Clinical Standards and Quality/Clinical Standards Group The Centers for Medicare and Medicare Services March 4,2014 Key Themes The CMHC NPRM
More informationWELCOME. Payment will be expected at the time of service. Please remember our 24 hour cancellation notice.
WELCOME Those of us at Crossroads Counseling want to thank you for choosing to work with us and we want to make your time with us as productive as possible. In order to expedite the intake process, please
More informationState of Connecticut REGULATION of. Department of Social Services. Payment of Behavioral Health Clinic Services
R-39 Rev. 03/2012 (Title page) Page 1 of 17 IMPORTANT: Read instructions on back of last page (Certification Page) before completing this form. Failure to comply with instructions may cause disapproval
More informationIntellectual Disability Waiver Transition Plan Regarding Compliance with the HCBS Final Rule Elements July 30, 2014
Intellectual Disability Waiver Transition Plan Regarding Compliance with the HCBS Final Rule Elements July 30, 2014 Assessment of Waiver and Service Definitions Virginia is currently in the process of
More informationSample of new TCM SPA for CMS review.
Sample of new TCM SPA for CMS review. Supplement 1g to Attachment 3.1-A Page 1 Target Group (42 Code of Federal Regulations 441.18(8)(i) and 441.18(9)): Medicaid Eligible individuals, who are involved
More informationCHAPTER 24 ACCREDITATION OF PROVIDERS OF SERVICES TO PERSONS WITH MENTAL ILLNESS, MENTAL RETARDATION, AND DEVELOPMENTAL DISABILITIES PREAMBLE
Human Services[441] Ch 24, p.1 CHAPTER 24 ACCREDITATION OF PROVIDERS OF SERVICES TO PERSONS WITH MENTAL ILLNESS, MENTAL RETARDATION, AND DEVELOPMENTAL DISABILITIES PREAMBLE The mental health, mental retardation,
More informationPrior Authorization and Continued Stay Criteria for Adult Serious Mentally Ill (SMI) Behavioral Health Residential Facility
Prior Authorization and Continued Stay Criteria for Adult Serious Mentally Ill (SMI) Behavioral Health Residential Facility AUTHORIZATION CRITERIA FOR BEHAVIORAL HEALTH RESIDENTIAL FACILITY, ADULT Title
More informationWeekly Provider Q&A Session 3 rd Quarter 2017
Weekly Provider Q&A Session 3 rd Quarter 2017 Type Issue/Agenda Item Response/Outcome/Updates Are providers allowed to bill for the MHSS service while a member is in hospital/acute care? It is important
More informationSHELTER PLUS CARE REFERRAL/APPLICATION PACKET
SHELTER PLUS CARE REFERRAL/APPLICATION PACKET Updated August 2016 Applicant s Name: Date: Referral Source: Received Date: Staff: Fairview Recovery Services helps people with the disease of alcoholism,
More informationGUIDELINES FOR SCORING INDIVIDUAL RECORDS. Y = Meets Standard N = Does Not Meet Standard. N/A = Not Applicable
QUALITY OF DOCUMENTATION PHP GUIDELINES FOR SCORING INDIVIDUAL RECORDS Y = Meets Standard N = Does Not Meet Standard N/A = Not Applicable GUIDELINES FOR DETERMINING PROGRAM COMPLIANCE WITH STANDARDS Programs
More informationQuality Assurance. Peer Review Training
Quality Assurance Peer Review Training For individuals enrolled after 3/1/2012, is the Receipt of the Orientation Handbook &HIPAA Privacy Act 1 Acknowledgement signed by the individual in Carelogic? 2
More information1. Section Modifications
Table of Contents 1. Section Modifications... 1 2.... 2 2.1. Overview... 2 2.2. Division of Medicaid... 2 2.3. General Information... 2 2.3.1. Provider Qualifications... 2 2.3.2. Record Keeping... 2 2.3.3.
More informationProvider Treatment Record Audit Tool
Provider Treatment Record Audit Tool Provider Name: Discipline: Practice Name: Solo Group Provider ID Number: Provider Location: Address: Suite: (City) Phone Number: (State) Enrollee ID: Age: Diagnosis
More informationProvider Frequently Asked Questions (FAQ)
1. What behavioral health services does Magellan of Virginia manage for Virginia Medicaid? Covered Services Magellan is responsible for management of the behavioral health services for the fee-for-service
More informationDischarge and Follow-Up Planning. Presented by the Clinical and Quality Team
Discharge and Follow-Up Planning Presented by the Clinical and Quality Team After today s training you will be able to: Identify and summarize important information about discharge planning Have adequate
More informationChapter 2 Provider Responsibilities Unit 6: Behavioral Health Care Specialists
Chapter 2 Provider Responsibilities Unit 6: Health Care Specialists In This Unit Unit 6: Health Care Specialists General Information 2 Highmark s Health Programs 4 Accessibility Standards For Health Providers
More informationCynthia B. Jones, Director Department of Medical Assistance Services (DMAS)
Department of Medical Assistance Services 600 East Broad Street, Suite 1300 Richmond, Virginia 23219 MEDICAID MEMO http://www.dmas.state.va.us TO: FROM: SUBJECT: All Support Coordinators/Case Management
More informationTitle 22 Background & Updated Information State Plan Amendments Roles and Responsibilities Provider SUD Medical Director Physician Department of
Title 22 Background & Updated Information State Plan Amendments Roles and Responsibilities Provider SUD Medical Director Physician Department of Health Care Services (DHCS) County DMC Substance Use Disorder
More informationRyan White Part A. Quality Management
Quality Management Mental Health Services Broward County/Fort Lauderdale Eligible Metropolitan Area (EMA) The creation of this public document is fully funded by a federal Ryan White CARE Act Part A grant
More informationWV Birth to Three Rider B: Service Coordinator Agreement
WV Birth to Three Rider B: Service Coordinator Agreement This document is attached and incorporated into the Payee Agreement that is active and in force at the time of execution of this agreement, for:
More informationPayments for Residential Supports do not include payments for room and board, the cost of facility maintenance and upkeep.
Residential Supports: Level 1 and Level 1 AFL - H2016; Level 2 and Level 2 AFL - T2014; Level 3 and Level 3 AFL - T2020; Level 4 and Level 4 AFL - H2016HI; Level 5 and Level 5 AFL T2016HI Residential Supports
More informationRequest for an Amendment to a 1915(c) Home and Community-Based Services Waiver
Page 1 of 11 Request for an Amendment to a 1915(c) Home and Community-Based Services Waiver 1. Request Information A. The State of North Carolina requests approval for an amendment to the following Medicaid
More informationNew York Notice Form Notice of Psychologists Policies and Practices to Protect the Privacy of Your Health Information
New York Notice Form Notice of Psychologists Policies and Practices to Protect the Privacy of Your Health Information THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
More informationPRECERTIFICATION/AUTHORIZATION OF TREATMENT
PRECERTIFICATION/AUTHORIZATION OF TREATMENT EAP Treatment It is the policy of IEAP to use an EAP session for the initial assessment whenever possible. If IEAP only manages EAP services for a particular
More informationCHILD HEALTH SERVICES TARGETED CASE MANAGEMENT COVERAGE AND LIMITATIONS HANDBOOK
Florida Medicaid CHILD HEALTH SERVICES TARGETED CASE MANAGEMENT COVERAGE AND LIMITATIONS HANDBOOK Agency for Health Care Administration June 2012 UPDATE LOG CHILD HEALTH SERVICES TARGETED CASE MANAGEMENT
More informationSHELTER PLUS CARE REFERRAL/APPLICATION PACKET
SHELTER PLUS CARE REFERRAL/APPLICATION PACKET Applicant s Name: Date: Referral Source: Received Date: Staff: Fairview Recovery Services helps people with the disease of alcoholism, chemical dependency,
More informationPATIENT RIGHTS TO ACCESS PERSONAL MEDICAL RECORDS California Health & Safety Code Section
PATIENT RIGHTS TO ACCESS PERSONAL MEDICAL RECORDS California Health & Safety Code Section 123100-123149. 123100. The Legislature finds and declares that every person having ultimate responsibility for
More informationRyan White Part A Quality Management
Quality Management Mental Health Services Broward County/Fort Lauderdale Eligible Metropolitan Area (EMA) The creation of this public document is fully funded by a federal Ryan White CARE Act Part A grant
More informationRULES OF TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES OFFICE OF LICENSURE
RULES OF TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES OFFICE OF LICENSURE CHAPTER 0940-5-24 MINIMUM PROGRAM REQUIREMENTS FOR MENTAL RETARDATION TABLE OF CONTENTS 0940-5-24-.01 Health,
More informationTherapeutic Day Treatment: Service Request Authorization Updates. Presented by Clinical November 1, 2016
Therapeutic Day Treatment: Service Request Authorization Updates Presented by Clinical November 1, 2016 The Purpose of This Training To highlight the changes on the new Service Request Authorization (SRA)
More informationAcute Crisis Units. Shelly Rhodes, Provider Relations Manager
Acute Crisis Units Shelly Rhodes, Provider Relations Manager Shelly.Rhodes@beaconhealthoptions.com Training Agenda Agenda: Transition and Certification Coverage of Services Service Code Definition Documentation
More informationHIPAA PRIVACY RULE: ACCESS TO PROTECTED HEALTH INFORMATION. A. General Right to Access Protected Health Information 1
1 of 9 SUBJECT: HIPAA PRIVACY RULE: ACCESS TO PROTECTED HEALTH INFORMATION HIPAA CITE: 45 CFR 164.524 POLICY NUMBER: PAT - 601 ISSUED: April 14, 2003 I. POLICY: A. General Right to Access Protected Health
More informationPROS Clarification. Structured Skill Development and Support
PROS Clarification Guidance 1: Guidance 2: Guidance 3: Guidance 4: Guidance 5: Guidance 6: Guidance 7: Guidance 8: Guidance 9: IRP Development and Timeframes The PROS Assessment and Timeframes Progress
More informationRequest for Proposals for Transitional Living Centers
Request for Proposals for Transitional Living Centers I. Introduction: Central Iowa Community Services (CICS) is announcing this Request for Proposals (RFP) for the following counties: Boone, Franklin,
More informationDEVELOPMENTAL PROGRAMS BULLETIN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE
DEVELOPMENTAL PROGRAMS BULLETIN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE DATE OF ISSUE May 26, 2010 EFFECTIVE DATE May 26, 2010 NUMBER 00-10- 06 SUBJECT: Supports Coordination Services
More informationMental Retardation/Intellectual Disability Community Services Manual Chapter Subject. Provider Participation Requirements 2/8/2012 CHAPTER II
Subject Revision Date i CHAPTER PROVIDER PARTICIPATION REQUIREMENTS Subject Revision Date ii CHAPTER TABLE OF CONTENTS Participating Provider 1 Provider Enrollment 1 Requests for Participation 2 Participation
More informationNC INNOVATIONS WAIVER HANDBOOK
A Managed Care Organization of the NC Department of Health & Human Services NC INNOVATIONS WAIVER HANDBOOK Revised April 01, 2013 Sandhills Center provides access to services for mental health, intellectual
More informationRule 31 Table of Changes Date of Last Revision
New 245G Statute Language Original Rule 31 Language Language Changes 245G.01 DEFINITIONS 9530.6405 DEFINITIONS 245G.01, subdivision 1. Scope. 245G.01, subdivision 2. Administration of medication. 245G.01,
More informationINTEGRATED CASE MANAGEMENT ANNEX A
INTEGRATED CASE MANAGEMENT ANNEX A NAME OF AGENCY: CONTRACT NUMBER: CONTRACT TERM: TO BUDGET MATRIX CODE: 32 This Annex A specifies the Integrated Case Management services that the Provider Agency is authorized
More informationKANSAS MEDICAL ASSISTANCE PROGRAM. Fee-for-Service Provider Manual. Local Education Agency
Fee-for-Service Provider Manual Local Education Agency Updated 07.2018 Introduction PART II Section Page 7000 Local Education Agency Billing Instructions............ 7-1 7010 Local Education Agency Billing
More informationWYOMING MEDICAID PROGRAM
WYOMING MEDICAID PROGRAM COMMUNITY MENTAL HEALTH & SUBSTANCE USE TREATMENT SERVICES MANUAL MENTAL HEALTH/SUBSTANCE USE REHABILITATION OPTION EPSDT CHILD & ADOLESCENT MENTAL HEALTH SERVICES TARGETED CASE
More informationPolicy Issuer (Unit/Program) Policy Number. Effective Date Revision Date Functional Area: Chart Review Non Hospital Services
County of Sacramento Department of Health and Human Services Division of Behavioral Health Services Policy and Procedure Title: Out of County Authorization, Documentation and Billing Procedure Approved
More informationCOMMCARE and Independence Waiver Renewals Aging, Attendant Care and OBRA Waiver Amendments Side-by-Side Comparison of Current and Revised Language
Appendix and Waiver Section Current Language Revised Language Waiver Affected Commenter Name, Date Submitted and Comment Appendix A: Waiver Administration and Operation Appendix A-2-a. Medicaid Director
More informationThis notice describes Florida Hospital DeLand s practices and that of: All departments and units of Florida Hospital DeLand.
MRN: FIN: FLORIDA HOSPITAL DELAND HIPAA NOTICE OF PRIVACY PRACTICES Effective Date: September 23, 2013 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
More information12057 Jefferson Blvd LA, CA (323)
Playa Vista Mental Health General Adult and Women s Psychiatry 12057 Jefferson Blvd LA, CA 90230 (323) 813-6218 Please read and complete each of the sections listed below as completely as possible. NEW
More informationProspective Provider Information Form Organizational / Group Behavioral Health and Substance Use Providers
Prospective Provider Information Form Organizational / Group Behavioral Health and Substance Use Providers Please review our current provider network needs outlined on the Health Share of Oregon website
More informationKing County Regional Support Network
Appendix 1 King County Regional Support Network External Quality Review Report Division of Behavioral Health and Recovery January 2016 Qualis Health prepared this report under contract with the Washington
More informationGUIDELINES FOR SCORING INDIVIDUAL RECORDS. Y = Meets Standard N = Does Not Meet Standard. N/A = Not Applicable
QUALITY OF DOCUMENTATION IOP GUIDELINES FOR SCORING INDIVIDUAL RECORDS Y = Meets Standard N = Does Not Meet Standard N/A = Not Applicable GUIDELINES FOR DETERMINING PROGRAM COMPLIANCE WITH STANDARDS Programs
More informationNEW MEXICO DEPARTMENT OF HEALTH DEVELOPMENTAL DISABILITIES SUPPORTS DIVISION MEDICALLY FRAGILE WAIVER (MFW)
NEW MEXICO DEPARTMENT OF HEALTH DEVELOPMENTAL DISABILITIES SUPPORTS DIVISION MEDICALLY FRAGILE WAIVER (MFW) CASE MANAGEMENT Effective January 1, 2011 MFW case management is a collaborative process of assessment,
More informationMeeting Notes. These notes are intended to summarize the issues and comments discussed at the meeting; they do not represent
PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES OFFICE OF DEVELOPMENTAL PROGRAMS HOME AND COMMUNITY-BASED INTELLECTUAL DISABILITY AND AUTISM SERVICES CHAPTER 6100 REGULATIONS WORK GROUP March 4, 2015, 10:00
More informationInformed Consent for Assessment
Informed Consent for Assessment Thank you for making the decision to pursue an evaluation with me. This document contains important information about my professional services and business policies. Please
More informationMental Health and Substance Abuse Services Bulletin COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE. Effective Date:
Mental Health and Substance Abuse Services Bulletin COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE Date of Issue: July 30, 1993 Effective Date: April 1, 1993 Number: OMH-93-09 Subject By Resource
More informationDr. Kinsler & Associates, LLC Help when life hurts
Dr. Kinsler & Associates, LLC Help when life hurts PREMARITAL COUNSELING INTAKE Bride s Name: WEDDING DATE: Age: Birthdate: Birthplace: Address: City: State: Zip: Phone: Highest level of education (grade/degree):
More informationParental Consent For Minors to Receive Services
Parental Consent For Minors to Receive Services Welcome to the University of San Diego s Wellness Area! We appreciate your coming our way, and look forward to working with you. The following provides important
More informationResidential Treatment Services Manual 6/30/2017. Provider Participation Requirements PROVIDER PARTICIPATION REQUIREMENTS CHAPTER II. Chapter.
Subject 1 PROVIDER PARTICIPATION REQUIREMENTS CHAPTER Subject 2 CHAPTER TABLE OF CONTENTS PAGE Managed Care Enrolled Members... 4... 5 Provider Qualifications... 7 Psychiatric Residential Treatment Facilities...
More informationProvider Frequently Asked Questions
Provider Frequently Asked Questions Strengthening Clinical Processes Training CASE MANAGEMENT: Q1: Does Optum allow Case Managers to bill for services provided when the Member is not present? A1: Optum
More informationPatient Name: Date of Birth:
: Patient Agreement Welcome to Community Psychiatry Community Psychiatry s dedicated providers and staff are committed to ensuring that each and every patient receives the highest quality psychiatry services
More informationFREQUENTLY ASKED QUESTIONS TARGETED SERVICES MANAGEMENT BULLETIN
Individual must be residing in a community setting, be eligible for Medical Assistance (MA) and have Intellectual Disability (ID) diagnosis in order to bill for Targeted Services Management (TSM) so that
More informationRYAN WHITE TITLE I SERVICE STANDARDS
RYAN WHITE TITLE I SERVICE STANDARDS 2 0 0 5 Chicago Area HIV Services Planning Council Chicago Department of Public Health Division of STD/HIV/AIDS Public Policy and Programs In collaboration with Midwest
More informationFor Substance Abuse Emergencies: Wright County will seek reimbursement for any and all services.
Wright County Community Services 115 1 st Street South East Post Office Box 4 Clarion, Iowa 50525 Phone: 515 532 3309 Fax: 515 532 6064 E Mail: wccs@trvnet.net Revised 8/1/2001 For Substance Abuse Emergencies:
More informationKANSAS MEDICAL ASSISTANCE PROGRAM. Fee-for-Service Provider Manual. Non-PIHP Alcohol and Substance Abuse Community Based Services
Fee-for-Service Provider Manual Non-PIHP Alcohol and Substance Abuse Community Based Services Updated 08.2015 PART II Introduction Section 7000 7010 8100 8200 8300 8400 Appendix BILLING INSTRUCTIONS Alcohol
More informationPatient Registration Form Pediatrics
Patient Registration Form Pediatrics For Office Use Only: Visit Date: Initials: PATIENT INFORMATION Preferred Language: English Spanish Other: Patient s Last Name First Middle Initial Date of Birth Sex
More informationDepartment of Juvenile Justice Guidance Document COMPLIANCE MANUAL 6VAC REGULATION GOVERNING JUVENILE SECURE DETENTION CENTERS
COMPLIANCE MANUAL 6VAC35-101 REGULATION GOVERNING JUVENILE SECURE DETENTION CENTERS This document shall serve as the compliance manual for the Regulation Governing Juvenile Secure Detention Centers 6VAC35-101)
More informationRoger A. Olsen, Psy.D., L.P Slater Road, Suite 210 Eagan, MN Phone: FAX:
Roger A. Olsen, Psy.D., L.P. 4660 Slater Road, Suite 210 Eagan, MN 55122 Phone: 651-882-6299 FAX: 651-683-0057 INFORMATION FOR NEW CLIENTS Welcome to my practice. This document contains important information
More informationFamily Preservation and Stabilization Services
Services DEFINITION Services provide crisis intervention, therapy, counseling, education, support, and advocacy to families who are coping with circumstances that put children at risk of being separated
More informationMACOMB COUNTY COMMUNITY MENTAL HEALTH ACKNOWLEDGMENT AND CONSENT FORM
MACOMB COUNTY COMMUNITY MENTAL HEALTH ACKNOWLEDGMENT AND CONSENT FORM IDENTIFYING INFORMATION PROVIDED INFORMATION Consumer was provided with the following information: Membership Information 1. MCCMH
More informationQuality Improvement Work Plan
NEVADA County Behavioral Health Quality Improvement Work Plan Mental Health and Substance Use Disorder Services Fiscal Year 2017-2018 Table of Contents I. Quality Improvement Program Overview...1 A. QI
More informationCommunity Benefits Program Annual Strategic Grants FY2015 Request for Proposal (RFP)
Community Benefits Program Annual Strategic Grants FY2015 Request for Proposal (RFP) Cape Cod Healthcare Office of Community Benefits 88 Lewis Bay Road Hyannis, MA 02601 OVERVIEW: COMMUNITY BENEFITS STRATEGIC
More informationSUBSTANCE ABUSE SERVICES-OUTPATIENT
SUBSTANCE ABUSE SERVICES-OUTPATIENT A. DEFINITION OF SERVICE HRSA Definition: Substance abuse services outpatient is the provision of medical or other treatment and/or counseling to address substance abuse
More informationPage 1 CHAPTER 31 SCREENING OUTREACH PROGRAM. 10: Screening process and procedures
Page 1 CHAPTER 31 SCREENING OUTREACH PROGRAM 10:31-2.3 Screening process and procedures (a) The screening process shall involve a thorough assessment of the client and his or her current situation to determine
More informationNavigating Work Life Health. Affiliate Clinical Forms
Navigating Work Life Health Affiliate Clinical Forms Introduction Lytle EAP Partners is an independent consulting and service organization that provides development, implementation, and administration
More informationAGREEMENT FOR SERVICE / INFORMED CONSENT FOR MINORS
Introduction AGREEMENT FOR SERVICE / INFORMED CONSENT FOR MINORS This Agreement has been created for the purpose of outlining the terms and conditions of services to be provided by San Diego Psychotherapy
More informationOHIO DEPARTMENT OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES NEW FUTURES WAIVER
OHIO DEPARTMENT OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES NEW FUTURES WAIVER CONCEPT PAPER SUBMITTED TO CMS Brief Waiver Description Ohio intends to create a 1915c Home and Community-Based Services
More informationCovered Service Codes and Definitions
Covered Service Codes and Definitions [01] Assessment Assessment services include the systematic collection and integrated review of individualspecific data, such as examinations and evaluations. This
More informationHIPAA Privacy Rule and Sharing Information Related to Mental Health
HIPAA Privacy Rule and Sharing Information Related to Mental Health Background The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule provides consumers with important privacy rights
More informationProviding and Documenting Medically Necessary Behavioral Health Services
Providing and Documenting Medically Necessary Behavioral Health Services Presented by: David Reed, Office Chief, Division of Behavioral Health and Recovery Marc Bollinger, LISCW, CEO, Great Rivers BHO
More informationPerson-Centered Treatment Plan and Managing Outpatient & Home- and Community-Based Services
Person-Centered Treatment Plan and Managing Outpatient & Home- and Community-Based Services Agenda Person-Centered Treatment Plan Overview Eligibility Process Person-Centered Treatment Plan Process Descriptions
More informationDetermination of Compliance: The Division of Health Improvement, Quality Management Bureau has determined your agency is in:
Date: October 18, 2012 To: Pat Posey, President Provider: A New Vision Case Management, Inc. Address: P.O. Box 56685 State/Zip: Albuquerque, New Mexico 87187 E-mail Address: anewvisioncm@aol.com Region:
More informationBehavioral Health Initial Review Form
Behavioral Health Initial Review Form https://providers.amerigroup.com This form is for inpatients, the Partial Hospitalization Program and the Intensive Outpatient Program. Please submit this form on
More informationBehavioral Health Documentation Training
Behavioral Health Documentation Training Targeted Case Management Turning the Key to Recovery every day with our attitude and our actions May 2017 Learning objectives Understand the myths and truths about
More informationMedicaid RAC Audit Results
Medicaid RAC Audit Results Clinical Audits: The RAC Clinical audit goal was to review supporting documentation for necessity of admission and continued stay in long term care for Medicaid residents. There
More informationVirginia s Settlement Agreement with the U.S. Department of Justice (DOJ) and Proposed Plan to Implement the Terms of the Agreement
FACT SHEET Virginia s Settlement Agreement with the U.S. Department of Justice (DOJ) and Proposed Plan to Implement the Terms of the Agreement Contents Overview Target Population Addition of Waiver Slots
More informationRULES OF THE TENNESSEE DEPARTMENT OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES OFFICE OF LICENSURE
RULES OF THE TENNESSEE DEPARTMENT OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES OFFICE OF LICENSURE CHAPTER 0465-02-17 MINIMUM PROGRAM REQUIREMENTS FOR INTELLECTUAL AND DEVELOPMENTAL DISABILITIES PERSONAL
More informationCCBHC CARE COORDINATION AGREEMENTS: OVERVIEW OF LEGAL REQUIREMENTS AND CHECKLIST OF RECOMMENDED TERMS
CCBHC CARE COORDINATION AGREEMENTS: OVERVIEW OF LEGAL REQUIREMENTS AND CHECKLIST OF RECOMMENDED TERMS Coordinating care across a spectrum of services, 29 including physical health, behavioral health, social
More informationNOTICE OF PRIVACY PRACTICES
BUTTE COUNTY DEPARTMENT OF BEHAVIORAL HEALTH NOTICE OF PRIVACY PRACTICES Effective Date: 4/14/2003 THIS NOTICE DESCRIBES NOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS
More informationTreatment Planning. General Considerations
Treatment Planning CBH Compliance has been tasked with ensuring that our providers adhere to documentation standards presented in state regulations, bulletins, CBH contractual documents, etc. Complying
More informationDocumentation Training for SUD Providers. Colorado Health Partnerships September, 2014
Documentation Training for SUD Providers Colorado Health Partnerships September, 2014 Healthcare World is Changing! Government healthcare programs seek to combat waste, fraud & abuse Medicaid (and Medicare)
More information