Long Island Regional Behavioral Health Organization (BHO) Inpatient Mental Health/Substance Abuse Services Kick-Off

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Long Island Regional Behavioral Health Organization (BHO) Inpatient Mental Health/Substance Abuse Services Kick-Off"

Transcription

1 Long Island Regional Behavioral Health Organization (BHO) Inpatient Mental Health/Substance Abuse Services Kick-Off 1

2 Objectives Welcome and Introductions. Philosophy of BHM. Overview of BHM. Clinical Requirements. ProviderConnect Demo. Questions and Answers. 2

3 3 Program Overview

4 Long Island Behavioral Health Management (BHM) Mission To improve the outcomes of those receiving mental health and substance abuse services within the region by: encouraging and facilitating region-wide multi-stakeholder collaboration/communication supporting the emergence of Health Homes in the region strengthening provider efforts toward more effective discharge planning reducing preventable readmissions encouraging the application of evidence based practices and quality improvement efforts collecting and reporting on data to inform and enhance local and state government regional planning efforts advancing the principles of recovery and resiliency preparing the region s public behavioral health care system, and relevant health and human services partners for the advent of responsively integrated managed health care reform in

5 Long Island Behavioral Health Management (BHM) Vision BHM is committed to supporting and advancing the development of an integrated, efficient, reliable and recovery-focused regional service delivery system that is flexible and innovative, assuring timely and appropriate access to the right service at the right time in order to responsively address the person-centered mental health and chemical dependency needs of those receiving services within the region. 5

6 Long Island Behavioral Health Management (BHM) Overview A partnership between ValueOptions and the North Shore LIJ Health System. Care management leadership to the Long Island Region for the treatment services and support required by Medicaid-eligible adults with serious mental illnesses and substance use disorders whose behavioral health needs are not covered by NYS Medicaid Health Plans, as well as children and youth diagnosed with a serious emotional disturbance. 6

7 Long Island Behavioral Health Management (BHM) Overview BHO initiative will include: Monitoring and improving the efficiency of inpatient services. Support and assistance to reduce avoidable readmissions and improve rapid linkage with required outpatient services postdischarge. Reduce regional service fragmentation through active outreach and communication with all components of the inpatient and outpatient behavioral health service delivery system. Systems advocacy efforts to focus on peer wellness and navigation services, particularly for high risk individuals who have fallen out of care and are at risk for emergency hospitalization or incarceration. Suicide prevention protocols into all aspects of clinical care management operations. 7

8 8 Clinical Requirements

9 Utilization Management Inpatient requests are completed either through the web or telephonically by calling the dedicated toll free number BHM Staff are available from Monday -Friday from 8:30 AM to 5:00 PM. 9

10 Program Requirements Inpatient Providers Notification: Providers are required to notify BHM of all Inpatient admissions within 24 hours of admission, except for admissions which occur on a weekend or holiday. Then notification would be required by 5 P.M. of the next business day following such weekend or holiday. Initial Review: Providers are required to provide initial review information for all members within 72 hours after admission. Concurrent Review: Providers are required to provide concurrent review at regular intervals. Discharge Review: Provider to complete and submit a discharge review no later than 24 hours post discharge. 10

11 Admission Notification Form 11

12 Initial Inpatient Review Initial Review Providers can notify BHM by telephone ( ), fax ( ), or by submitting information through the BHM website. ProviderConnect, accessible through the BHM website, is the preferred method for notification. The BHM website can be accessed through ( 12

13 Initial Inpatient Review (page 1 of 4) 13

14 Initial Inpatient Review (page 2 of 4) 14

15 Initial Inpatient Review (page 3 of 4) 15

16 Initial Inpatient Review (page 4 of 4) 16

17 Concurrent Inpatient Review Concurrent Review A Concurrent Inpatient Review can be submitted as an attachment in ProviderConnect, accessible through the BHM website, or can be faxed to BHM at The BHM website can be accessed through ( 17

18 Concurrent Review (page 1 of 4) 18

19 Concurrent Review (page 2 of 4) 19

20 Concurrent Review (page 3 of 4) 20

21 Concurrent Review (page 4 of 4) 21

22 Discharge Review Discharge Review The Discharge Review can be submitted as an attachment in ProviderConnect, accessible through the BHM website, or can be faxed to BHM at The BHM website can be accessed through ( 22

23 Discharge Review (page 1 of 4) 23

24 Discharge Review (page 2 of 4) 24

25 Discharge Review (page 3 of 4) 25

26 Discharge Review (page 4 of 4) 26

27 27 Demonstration of ProviderConnect

28 ProviderConnect (Provider Online Services) What is ProviderConnect? An online tool where providers can: Access ProviderConnect message center. Access and print forms. Enter notification and clinical information. Submit customer service inquiries. Submit updates to provider demographic information. Increased convenience, decreased administrative processes. 28

29 ProviderConnect Benefits What are the benefits of ProviderConnect? Free and secure online application. Access routine information 24 hours a day, 7 days a week. Complete multiple transactions in single sitting. View and print information. Reduce calls for routine information. 29

30 Accessing ProviderConnect? Go to choose Providers. All in-network providers can self register for ProviderConnect using their provider ID number. Self-registration is only available for the first registrant for each facility ID number. If additional ProviderConnect log ons for that same provider ID number are desired, please do the following: Fill out the Online Provider Services Account Request Form and fax the completed form to Additional log on turnaround time is 2 business days. ProviderConnect registration questions or questions about the form referenced above please contact the ValueOptions EDI Helpdesk at (Monday to Friday, 8:00 a.m. - 6:00 p.m. ET) 30

31 31

32 32

33 ProviderConnect Registration 33

34 ProviderConnect Registration 34

35 ProviderConnect Login Screen 35

36 User Agreement Page 36

37 ProviderConnect Home Page 37

38 Attaching a Document to an Inquiry 38

39 39 Questions & Answers

40 40 Thank You

New York State Behavioral Health Organizations 2012 Summary. NYS Offices of Mental Health and Alcoholism and Substance Abuse Services

New York State Behavioral Health Organizations 2012 Summary. NYS Offices of Mental Health and Alcoholism and Substance Abuse Services New York State Behavioral Health Organizations 2012 Summary NYS Offices of Mental Health and Alcoholism and Substance Abuse Services Phase 1 BHOs: Administrative Services Organizations Charge to BHOs:

More information

OSCAR Health Insurance Frequently Asked Questions/General Information

OSCAR Health Insurance Frequently Asked Questions/General Information Q: What is the relationship between Oscar and ValueOptions? A. ValueOptions administers the mental health and substance abuse benefits for Oscar Health Insurance. They have contracted with ValueOptions,

More information

Before submitting claims online you must complete the following form(s): Online Provider Services Account Request Form (www.valueoptions.

Before submitting claims online you must complete the following form(s): Online Provider Services Account Request Form (www.valueoptions. EDI RESOURCE DOCUMENT/ E-SUPPORT SERVICES PROVIDERCONNECT AND ELECTRONIC CLAIMS ValueOptions is committed to helping our providers manage administrative functions more efficiently and conveniently, and

More information

An Administrative Orientation for Providers for Oscar Health Insurance

An Administrative Orientation for Providers for Oscar Health Insurance An Administrative Orientation for Providers for Oscar Health Insurance Objectives Overview of ValueOptions Overview of ValueOptions & Oscar Partnership Overview of Operational Areas Clinical Operations

More information

OptumHealth NYC BHO Provider Training

OptumHealth NYC BHO Provider Training OptumHealth NYC BHO Provider Training Agenda Introductions Overview of Optum Review of Contract between Optum and the Offices Admission & Discharge Review Provider Tools Tool Review Forms & Submission

More information

Provider Orientation Training Webinar

Provider Orientation Training Webinar Provider Orientation Training Webinar For Audio Call: (877) 563-4796 Enter Code: 7771224 Please mute your phones by pressing *6 Training Topics Administrative Orientation Welcome and Introductions Overview

More information

Applied Behavior Analysts (ABA) Provider Orientation

Applied Behavior Analysts (ABA) Provider Orientation Applied Behavior Analysts (ABA) Provider Orientation Objectives Overview of Horizon Behavioral Health and ValueOptions Qualified ABA Services and Covered Treatment Providers Covered ABA Codes/AMA CPT Codes

More information

Applied Behavior Analysis (ABA) Authorization & Billing Process for MBHP September 2015. MBHP is a Beacon Health Options company.

Applied Behavior Analysis (ABA) Authorization & Billing Process for MBHP September 2015. MBHP is a Beacon Health Options company. Applied Behavior Analysis (ABA) Authorization & Billing Process for MBHP September 2015 MBHP is a Beacon Health Options company. 1 Objectives Overview of Billing Codes and Modifier requirement used by

More information

UTILIZATION MANGEMENT

UTILIZATION MANGEMENT UTILIZATION MANGEMENT The Anthem Health Care Management Division has a singular dynamic focus - to continually improve the system of health care delivery that influences utilization and cost of services

More information

Behavioral Health. ProviderConnect Registered Services User Manual

Behavioral Health. ProviderConnect Registered Services User Manual Behavioral Health ProviderConnect Registered Services User Manual 3 IT Product Support - Reston, VA. This page was intentionally left blank. Table of Contents Introduction... 3 Accessing ProviderConnect...

More information

Unit 1 Core Care Management Activities

Unit 1 Core Care Management Activities Unit 1 Core Care Management Activities Healthcare Management Services Healthcare Management Services (HMS) is responsible for all the medical management services provided to Highmark Blue Shield members,

More information

Online Provider Services Account Request Form (www.valueoptions.com)

Online Provider Services Account Request Form (www.valueoptions.com) PROVIDERCONNECT AND ELECTRONIC CLAIMS SUBMISSION ValueOptions is committed to helping its providers manage administration functions more efficiently and conveniently, and encourages providers to take advantage

More information

ValueOptions Provider Guide to using Single Claim Submission

ValueOptions Provider Guide to using Single Claim Submission ValueOptions Provider Guide to using Single Claim Submission www.valueoptions.com You may only use Single Claim Submission for outpatient claims. Inpatient claims may not be entered through Single Claim

More information

CT Behavioral Health Partnership

CT Behavioral Health Partnership CT Behavioral Health Partnership October 8, 2014 Copyright 2014 ValueOptions Connecticut. All rights reserved. CT Behavioral Health Partnership Overview 2006 - Partnership Formed Partnership between Dept

More information

Social & Emotional Support Resources & Hotline

Social & Emotional Support Resources & Hotline Social & Emotional Support Resources & Hotline Suicide Depression - Suicide and Crisis Hotlines Toll-Free/24 Hours/7 Days a Week 1.800.SUICIDE (784-2433) 1.800.273.TALK (8255) http://www.suicidehotlines.com

More information

Assertive Community Treatment (ACT) Providing Health Home Care Management Interim Instruction: February 19, 2014

Assertive Community Treatment (ACT) Providing Health Home Care Management Interim Instruction: February 19, 2014 Assertive Community Treatment (ACT) Providing Health Home Care Management Interim Instruction: February 19, 2014 Introduction The Office of Mental Health (OMH) licensed and regulated Assertive Community

More information

Behavioral Health Provider Training: Program Overview & Helpful Information

Behavioral Health Provider Training: Program Overview & Helpful Information Behavioral Health Provider Training: Program Overview & Helpful Information Overview The Passport Behavioral Health Program provides members with access to a full continuum of recovery and resiliency focused

More information

ASSERTIVE COMMUNITY TREATMENT TEAMS CERTIFICATION

ASSERTIVE COMMUNITY TREATMENT TEAMS CERTIFICATION ARTICLE 5.2. ASSERTIVE COMMUNITY TREATMENT TEAMS CERTIFICATION Rule 1. Definitions 440 IAC 5.2-1-1 Applicability Sec. 1. The definitions in this rule apply throughout this article. (Division of Mental

More information

Assertive Community Treatment (ACT) Providing Health Home Care Management Interim Instruction: December 6, 2013

Assertive Community Treatment (ACT) Providing Health Home Care Management Interim Instruction: December 6, 2013 Assertive Community Treatment (ACT) Providing Health Home Care Management Interim Instruction: December 6, 2013 Introduction The OMH licensed and regulated Assertive Community Treatment Program (ACT) will

More information

OUR MISSION. WestCare s mission. is to empower everyone whom. we come into contact with. to engage in a process of healing, growth and change,

OUR MISSION. WestCare s mission. is to empower everyone whom. we come into contact with. to engage in a process of healing, growth and change, OUR MISSION WestCare s mission is to empower everyone whom we come into contact with to engage in a process of healing, growth and change, benefiting themselves, their families, coworkers and communities.

More information

Understanding Behavioral Health Readmissions. Summary of the work of the Western Regional Behavioral Health Organization (WRBHO)

Understanding Behavioral Health Readmissions. Summary of the work of the Western Regional Behavioral Health Organization (WRBHO) Finger Lakes Health Systems Agency Understanding Behavioral Health Readmissions Summary of the work of the Western Regional Behavioral Health Organization (WRBHO) Regional Commission on Community Health

More information

TREATMENT MODALITIES. May, 2013

TREATMENT MODALITIES. May, 2013 TREATMENT MODALITIES May, 2013 Treatment Modalities New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) regulates the addiction treatment modalities offered in New York State.

More information

Provider enews TREATING PRESCRIPTION DRUG ADDICTION

Provider enews TREATING PRESCRIPTION DRUG ADDICTION Provider enews TREATING PRESCRIPTION DRUG ADDICTION Treating addiction to prescription opioids July 2012 Several options are available for effectively treating prescription opioid addiction. These options

More information

Helping. Healing.Offering Hope.

Helping. Healing.Offering Hope. Helping. Healing.Offering Hope. Directory of Services 2009-2010 w w w. p e a c e r i v e r c e n t e r. o r g Rev. 3/10 Years Peace River Center is a Private, Not-For-Profit Community Mental Health Organization

More information

Medical Management. G.2 At a Glance. G.3 Procedures Requiring Prior Authorization. G.5 How to Contact or Notify Medical Management

Medical Management. G.2 At a Glance. G.3 Procedures Requiring Prior Authorization. G.5 How to Contact or Notify Medical Management Page1 G.2 At a Glance G.3 Procedures Requiring Prior Authorization G.5 How to Contact or Notify G.6 When to Notify G.11 Case Management Services G.14 Special Needs Services G.16 Health Management Programs

More information

Use Agreement. 1. ProviderConnect Use Agreement = Must read and select I agree at the bottom

Use Agreement. 1. ProviderConnect Use Agreement = Must read and select I agree at the bottom Accessing ProviderConnect 1. Go to the Value Behavioral Health of Pennsylvania homepage: www.vbh-pa.com 2. Select bar labeled = For Providers Provider Online Services 1. ProviderConnect = Log in if User

More information

Medicaid Substance Abuse Treatment Self-Referral Protocols Substance Abuse Improvement Initiative (SAII) January 1, 2010

Medicaid Substance Abuse Treatment Self-Referral Protocols Substance Abuse Improvement Initiative (SAII) January 1, 2010 Medicaid Substance Abuse Treatment Self-Referral Protocols Substance Abuse Improvement Initiative (SAII) January 1, 2010 The Substance Abuse Improvement Initiative (SAII) allows Medicaid enrollees to select

More information

Nursing Home to Community Program: A Discharge Planning Manual

Nursing Home to Community Program: A Discharge Planning Manual Nursing Home to Community Program: A Discharge Planning Manual March 2006 Portions of this Manual may be cited on condition that proper credit is given to: Broome County Community Alternative Systems Agency

More information

Optum By United Behavioral Health. 2015 Mississippi Coordinated Access Network (CAN) Medicaid Level of Care Guidelines

Optum By United Behavioral Health. 2015 Mississippi Coordinated Access Network (CAN) Medicaid Level of Care Guidelines Optum By United Behavioral Health 2015 Mississippi Coordinated Access Network (CAN) Medicaid Level of Care Guidelines is a behavioral intervention program, provided in the context of a therapeutic milieu,

More information

Substance Abuse Summit October 7, 2013

Substance Abuse Summit October 7, 2013 Substance Abuse Summit October 7, 2013 Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) Services Today o Program Description o Managed Care Requirements o Responses to Questions Submitted

More information

ONONDAGA CASE MANAGEMENT SERVICES, INC.

ONONDAGA CASE MANAGEMENT SERVICES, INC. ONONDAGA CASE MANAGEMENT SERVICES, INC. in collaboration with New York Care Coordination Program, Inc. and Beacon Health Strategies, LLC Agenda Provide overview of the Provider Led Model Introduce Onondaga

More information

NORTH COUNTRY COMMUNITY MENTAL HEALTH NORTHERN AFFILIATION ACCESS TO CARE PROGRAM PLAN Revised January 2013

NORTH COUNTRY COMMUNITY MENTAL HEALTH NORTHERN AFFILIATION ACCESS TO CARE PROGRAM PLAN Revised January 2013 NORTH COUNTRY COMMUNITY MENTAL HEALTH NORTHERN AFFILIATION ACCESS TO CARE PROGRAM PLAN Revised January 2013 I. Mission II. Scope III. Philosophy IV. Authority V. Program Review VI. Capacity Analysis VII.

More information

A Breakthrough Approach to Integrating Substance Use and Mental Health Treatment. Susan Whitley, MD Director of Chemical Dependency Services

A Breakthrough Approach to Integrating Substance Use and Mental Health Treatment. Susan Whitley, MD Director of Chemical Dependency Services A Breakthrough Approach to Integrating Substance Use and Mental Health Treatment Susan Whitley, MD Director of Chemical Dependency Services Date: September 17-21, 2012 In spite of the high percentage of

More information

Behavioral Health Organizations in New York State. October 2011

Behavioral Health Organizations in New York State. October 2011 Behavioral Health Organizations in New York State October 2011 Brief Background New York State hopes to enroll all medicaid beneficiaries into some form of care management by June 2013. Enacted MRT recommendation

More information

Kitsap County has a retail sales tax to fund a county wide infrastructure for behavioral health treatment programs and services. Substance abuse and

Kitsap County has a retail sales tax to fund a county wide infrastructure for behavioral health treatment programs and services. Substance abuse and Kitsap County has a retail sales tax to fund a county wide infrastructure for behavioral health treatment programs and services. Substance abuse and mental health services are viewed as existing on a continuum

More information

Assertive Community Treatment/Case Management Services/ Health Home Care Management 2012-13 NYC 2013 Upstate/Downstate

Assertive Community Treatment/Case Management Services/ Health Home Care Management 2012-13 NYC 2013 Upstate/Downstate Assertive Community Treatment/Case Services/ Health Home Care 2012-13 NYC 2013 Upstate/Downstate Please be advised that, due to delays with the conversion of Adult Targeted Case (TCM) to Health Home Care

More information

Human Energy. Yours. TM

Human Energy. Yours. TM Human Energy. Yours. TM Chevron Global Choice Plan (U.S.-Payroll Expatriates) (008) Summary of Benefits and Coverage What This Plan Covers and What it Costs Coverage Period January 1, 2015 December 31,

More information

Arkansas Behavioral Health Home State Plan Amendment. Draft - 03/11/14

Arkansas Behavioral Health Home State Plan Amendment. Draft - 03/11/14 Arkansas Behavioral Health Home State Plan Amendment Draft - 03/11/14 NOTE: Bolded text within document denotes required health home language by the Centers for Medicare and Medicaid Services (CMS) with

More information

Certified Addiction Counselor INTERNSHIP PROGRAM

Certified Addiction Counselor INTERNSHIP PROGRAM Certified Addiction Counselor INTERNSHIP PROGRAM Updated: January 2016 ASPENPOINTE The AspenPointe family of organizations has provided healthcare solutions to Southern Colorado residents for over 130

More information

Idaho Health Home State Plan Amendment Matrix: Summary Overview. Overview of Approved Health Home SPAs

Idaho Health Home State Plan Amendment Matrix: Summary Overview. Overview of Approved Health Home SPAs Idaho Health Home State Plan Amendment Matrix: Summary Overview This matrix outlines key program design features from health home State Plan Amendments (SPAs) approved by the Centers for Medicare & Medicaid

More information

Transition from Targeted Case Management (TCM) to Health Home Care Management and non-medicaid funded Care Management (CM)

Transition from Targeted Case Management (TCM) to Health Home Care Management and non-medicaid funded Care Management (CM) Transition from Targeted Case Management (TCM) to Health Home Care Management and non-medicaid funded Care Management (CM) Interim Instruction: February 21, 2012 The New York State (NYS) Office of Mental

More information

COMMUNITY CRISIS STABILIZATION (CCS)

COMMUNITY CRISIS STABILIZATION (CCS) COMMUNITY CRISIS STABILIZATION (CCS) Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance specifications. Additionally,

More information

Performance Standards

Performance Standards Performance Standards Co-Occurring Disorder Competency Performance Standards are intended to provide a foundation and serve as a tool to promote continuous quality improvement and progression toward best

More information

OFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN

OFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN OFFICE OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES BULLETIN ISSUE DATE: EFFECTIVE DATE: NUMBER: June 15, 2009 June 15, 2009 OMHSAS-09-04 SUBJECT: Best Practice Guidelines for Family Involvement with

More information

Mental Health Support

Mental Health Support Mental Health Support A Guide to Mental Health Services in Brown County 300 S. Adams, Green Bay, WI 54301 920-448-4300 www.adrcofbrowncounty.org February 2014 Mental Health Support 2 I need help. Where

More information

Fairfax-Falls Church Community Services Board

Fairfax-Falls Church Community Services Board 106-06-Mental Health Adult Residential Services Fund/Agency: 106 Fairfax-Falls Church Community Services Board Personnel Services $5,855,252 Operating Expenses $5,664,614 Recovered Costs $0 Capital Equipment

More information

ABOUT US. and Expressive Therapy (Dance/Movement, Art, Drama) in addition to individual, group and family therapy by skilled therapists.

ABOUT US. and Expressive Therapy (Dance/Movement, Art, Drama) in addition to individual, group and family therapy by skilled therapists. ABOUT US n Riveredge Hospital maintains the treatment philosophy of Trauma Informed Care. n Our commitment to providing the highest quality of care includes offering Animal Assisted Therapy, and Expressive

More information

504 Lavaca Street Suite 850 Austin, Texas 78701 PROVIDER NEWSLETTER

504 Lavaca Street Suite 850 Austin, Texas 78701 PROVIDER NEWSLETTER 504 Lavaca Street Suite 850 Austin, Texas 78701 PROVIDER NEWSLETTER PROVIDER REPORT www.cenpatico.com Welcome to the first Cenpatico provider report for 2013. We re excited to share with you details on

More information

ASSERTIVE COMMUNITY TREATMENT TEAMS

ASSERTIVE COMMUNITY TREATMENT TEAMS ARTICLE 11. ASSERTIVE COMMUNITY TREATMENT TEAMS Rule 1. Definitions 440 IAC 11-1-1 Applicability Sec. 1. The definitions in this rule apply throughout this article. (Division of Mental Health and Addiction;

More information

CHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions...

CHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions... TABLE OF CONTENTS SECTION PAGE NUMBER Background... 2 Policy... 2 535.1 Member Eligibility and Enrollment... 2 535.2 Health Home Required Functions... 3 535.3 Health Home Coordination Role... 4 535.4 Health

More information

SECURE EDI ENROLLMENT AGREEMENT INSTRUCTIONS

SECURE EDI ENROLLMENT AGREEMENT INSTRUCTIONS Notification Secure EDI provides this agreement as a courtesy for our customers. We make every effort to keep these forms updated however; the payer may not always notify us when changes have been made

More information

Behavioral Health Review Mental Health

Behavioral Health Review Mental Health Behavioral Health Review Mental Health Name: Age: Insured ID: County: PH Plan: High need: Does the consumer have a history of D/A service: Has the consumer signed an ROI: Level of care Type of review:

More information

CHAPTER 5 SERVICE DESCRIPTIONS. Inpatient Hospital Psychiatric Services. Service Coverage

CHAPTER 5 SERVICE DESCRIPTIONS. Inpatient Hospital Psychiatric Services. Service Coverage CHAPTER 5 SERVICE DESCRIPTIONS Inpatient Hospital Psychiatric Services Service Coverage Inpatient psychiatric care involves skilled psychiatric services in a hospital setting. The care delivered includes

More information

Pre-Existing Condition Insurance Plan Program

Pre-Existing Condition Insurance Plan Program Pre-Existing Condition Insurance Plan Program Office of Insurance Programs Center for Consumer Information and Insurance Oversight Centers for Medicare & Medicaid Services Center for Consumer Information

More information

I. Introduction. A. Summary/Background

I. Introduction. A. Summary/Background rev 11/11 9. Person Centered Planning Policy and Practice Guideline (FY 12 contract attachment C3.4.1.1) 2002 PCP Practice Guideline Grid TR on Treatment Plan Review Committees (FY 12 contract attachment

More information

Alcohol & Drug Services. Programs and

Alcohol & Drug Services. Programs and Alcohol & Drug Services Programs and Services Alcohol and Drug Services Vision and Values Vision Empowering Yukoners to attain freedom from alcohol and other drug problems, in order to achieve health and

More information

Redesigning the Publicly-Funded Mental Health System in Texas

Redesigning the Publicly-Funded Mental Health System in Texas Redesigning the Publicly-Funded Mental Health System in Texas Access to care when services are needed Choice in health plans for consumers and providers Integration of care at the plan and provider level

More information

Medicaid Application for Intensive Outpatient Programs Application Checklist for Providers

Medicaid Application for Intensive Outpatient Programs Application Checklist for Providers Provider information Agency Name: Physical Address: If applying for multiple sites or applying to serve adolescents and/or adults please note and list specific physical locations: Mailing Address (if different

More information

The goal of Utilization Management (UM) is to ensure that all services that are authorized meet the Departments definition of medical necessity.

The goal of Utilization Management (UM) is to ensure that all services that are authorized meet the Departments definition of medical necessity. IV. Utilization Management and Care Management The primary vision that guided the development of the CT BHP was to develop an integrated public behavioral health service system that offers enhanced access

More information

GENERAL IMPLEMENTATION TRANSITION QUESTIONS

GENERAL IMPLEMENTATION TRANSITION QUESTIONS GENERAL IMPLEMENTATION TRANSITION QUESTIONS Q. When will ValueOptions begin to manage the MHSA plan for Michelin? A. ValueOptions will begin to manage the MHSA plan for Michelin on January 1, 2014. ValueOptions

More information

Sort by Position: 1:1 AIDE. Hillside Family of Agencies Employment Listings

Sort by Position: 1:1 AIDE. Hillside Family of Agencies Employment Listings Sort by Position: 1:1 AIDE Record # : 7806 Position: 1:1 AIDE Region: Monroe Date: 12/15/2015 Program: Halpern Education Center Location: Webster, NY Hours: Full Time - 35 hours - Monday - Friday - 7:45am

More information

Texas Resilience and Recovery

Texas Resilience and Recovery Texas Resilience and Recovery Utilization Management Guidelines Child & Adolescent Services Texas Resilience and Recovery Utilization Management Guidelines: Child and Adolescent Services Effective September

More information

I. General Instructions

I. General Instructions Contra Costa Behavioral Health Services Request for Proposals Mental Health Services Act (MHSA) Mental Health Recovery Centers October 16, 2013 I. General Instructions Contra Costa Behavioral Health Services

More information

ASSERTIVE COMMUNITY TREATMENT: ACT 101. Rebecca K. Sartor, LICSW

ASSERTIVE COMMUNITY TREATMENT: ACT 101. Rebecca K. Sartor, LICSW ASSERTIVE COMMUNITY TREATMENT: ACT 101 Rebecca K. Sartor, LICSW A LITTLE BIT ABOUT ME HOW I ENDED UP HERE LEARNING OBJECTIVES To develop an understanding of: How ACT Evolved Practice Principles Services

More information

Healthcare Associates Caring for You

Healthcare Associates Caring for You Healthcare Associates Caring for You Welcome to Healthcare Associates Dedicated to You At Healthcare Associates (HCA), patients come first, and caring for you is what we do best. We are pleased to offer

More information

MEDICAL ASSOCIATES HEALTH PLANS HEALTH CARE SERVICES POLICY AND PROCEDURE MANUAL POLICY NUMBER: PP 27

MEDICAL ASSOCIATES HEALTH PLANS HEALTH CARE SERVICES POLICY AND PROCEDURE MANUAL POLICY NUMBER: PP 27 POLICY TITLE: RESIDENTIAL TREATMENT CRITERIA POLICY STATEMENT: Provide consistent criteria when determining coverage for Residential Mental Health and Substance Abuse Treatment. NOTE: This policy applies

More information

Mental Health & Substance Abuse Services

Mental Health & Substance Abuse Services Mental Health & Substance Abuse Services Services Overview The Adult Behavioral Health (ABH) Department provides Mental Health and Substance Abuse services to clients who meet criteria for either Substance

More information

Florida Medicaid. Mental Health Targeted Case Management Handbook. Agency for Health Care Administration

Florida Medicaid. Mental Health Targeted Case Management Handbook. Agency for Health Care Administration Florida Medicaid Mental Health Targeted Case Management Handbook Agency for Health Care Administration JEB BUSH, GOVERNOR ALAN LEVINE, SECRETARY June 7, 2006 Dear Medicaid Provider: Enclosed please find

More information

INSTRUCTIONS AND PROTOCOLS FOR THE IMPLEMENTATION OF CASE MANAGEMENT SERVICES FOR INDIVIDUALS AND FAMILIES WITH SUBSTANCE USE DISORDERS

INSTRUCTIONS AND PROTOCOLS FOR THE IMPLEMENTATION OF CASE MANAGEMENT SERVICES FOR INDIVIDUALS AND FAMILIES WITH SUBSTANCE USE DISORDERS 201 Mulholland Bay City, MI 48708 P 989-497-1344 F 989-497-1348 www.riverhaven-ca.org Title: Case Management Protocol Original Date: March 30, 2009 Latest Revision Date: August 6, 2013 Approval/Release

More information

ASSERTIVE COMMUNITY TREATMENT (ACT) TEAM REQUEST FOR PROPOSALS. October 3, 2014

ASSERTIVE COMMUNITY TREATMENT (ACT) TEAM REQUEST FOR PROPOSALS. October 3, 2014 ASSERTIVE COMMUNITY TREATMENT (ACT) TEAM REQUEST FOR PROPOSALS INTRODUCTION October 3, 2014 New York State Office of Mental Health communicated the availability of reinvestment funding associated with

More information

Health Home Standards and Requirements for Health Homes, Care Management Providers and Managed Care Organizations (DRAFT AS OF 6/12/2015)

Health Home Standards and Requirements for Health Homes, Care Management Providers and Managed Care Organizations (DRAFT AS OF 6/12/2015) Health Home Standards and Requirements for Health Homes, Care Management Providers and Managed Care Organizations (DRAFT AS OF 6/12/2015) Introduction: The purpose of this guidance document is to explain

More information

Mental Health Rehabilitative Services and Mental Health Targeted Case Management TXPEC-0870-14

Mental Health Rehabilitative Services and Mental Health Targeted Case Management TXPEC-0870-14 Mental Health Rehabilitative Services and Mental Health Targeted Case Management TXPEC-0870-14 1 Agenda Key contacts Eligibility Mental Health Rehabilitative services (MHR) and Mental Health Targeted (TCM)

More information

FRN Research Report March 2011: Correlation between Patient Relapse and Mental Illness Post-Treatment

FRN Research Report March 2011: Correlation between Patient Relapse and Mental Illness Post-Treatment FRN Research Report March 2011: Correlation between Patient Relapse and Mental Illness Post-Treatment Background Studies show that more than 50% of patients who have been diagnosed with substance abuse

More information

Hotlines Athens County Children's Services Crisis Line Mon-Fri: 740-592-3061; Weekends, holidays, after hours: 877-477-0772

Hotlines Athens County Children's Services Crisis Line Mon-Fri: 740-592-3061; Weekends, holidays, after hours: 877-477-0772 2015 Healthcare Resource Guide Mental Health Programs and Substance Abuse Services Prepared by United Appeal for Athens County 2-1-1 Give help. Get Help. Call 2-1-1 or visit www.211athenscounty.org for

More information

Eligible Hospitals Meaningful Use Stage 1

Eligible Hospitals Meaningful Use Stage 1 South Dakota Medicaid EHR Incentive Payment Program Eligible Hospitals Meaningful Use Stage 1 User Guide 10/23/12 1 Eligible Hospitals Meaningful Use Stage 1 TABLE OF CONTENTS 1. Welcome Page: Account

More information

Employment Opportunities Administrative

Employment Opportunities Administrative David Lawrence Center is a not-for-profit, behavioral health agency that provides comprehensive, innovative mental health and substance abuse services in Southwest Florida. In addition to helping children

More information

Service Inventory of Managed Care Entities to Support Development of a Health Homes State Plan Amendment

Service Inventory of Managed Care Entities to Support Development of a Health Homes State Plan Amendment Service Inventory of Managed Care Entities to Support Development of a Health Homes State Plan Amendment March 2012 MassHealth Managed Care Entities (MCO, SCO, PACE) Health Homes Inventory to Support State

More information

How are Health Home Services Provided to the Medically Needy?

How are Health Home Services Provided to the Medically Needy? Id: NEW YORK State: New York Health Home Services Effective Date- January 1, 2012 SPA includes both Categorically Needy and Medically Needy Beneficiaries- check box 3.1 - A: Categorically Needy View Attachment

More information

Horizon Behavioral Health SM Provider Orientation. July 2014

Horizon Behavioral Health SM Provider Orientation. July 2014 Horizon Behavioral Health SM Provider Orientation July 2014 Objectives Overview of Horizon Behavioral Health Overview of Operational Areas Overview of ProviderConnect and NaviNet Claims Processing and

More information

What is CCS? Eligibility

What is CCS? Eligibility What is CCS? Department of Health Services Division of Mental Health and Substance Abuse Services Bureau of Prevention, Treatment and Recovery Services Comprehensive Community Services (CCS) Comprehensive

More information

[Mental Health Treatment and Services*] [Chemical Dependency Program (CDP)]

[Mental Health Treatment and Services*] [Chemical Dependency Program (CDP)] [Mental Health Treatment and Services*] Crisis intervention, stabilization, counseling, and medication management. *(TST funded through Thurston County Public Health and Social Services) 1. Early identification/connection

More information

Hamilton County Municipal and Common Pleas Court Guide

Hamilton County Municipal and Common Pleas Court Guide Hamilton County Municipal and Common Pleas Court Guide Updated July 2015 PREVENTION ASSESSMENT TREATMENT REINTEGRATION MUNICIPAL & COMMON PLEAS COURT GUIDE Table of Contents Table of Contents... 2 Municipal

More information

Allocation of Outpatient Mental Health Services and Beds in State Hospitals. As Required By H.B. 3793, 83rd Legislature, Regular Session, 2013

Allocation of Outpatient Mental Health Services and Beds in State Hospitals. As Required By H.B. 3793, 83rd Legislature, Regular Session, 2013 Allocation of Outpatient Mental Health Services and Beds in State Hospitals As Required By H.B. 3793, 83rd Legislature, Regular Session, 2013 Department of State Health Services January 2015 - This page

More information

CACREP STANDARDS: CLINICAL MENTAL HEALTH COUNSELING Students who are preparing to work as clinical mental health counselors will demonstrate the

CACREP STANDARDS: CLINICAL MENTAL HEALTH COUNSELING Students who are preparing to work as clinical mental health counselors will demonstrate the CACREP STANDARDS: CLINICAL MENTAL HEALTH COUNSELING Students who are preparing to work as clinical mental health counselors will demonstrate the professional knowledge, skills, and practices necessary

More information

Certified Community Behavioral Health Clinics

Certified Community Behavioral Health Clinics Certified Community Behavioral Health Clinics CCBHCs Stakeholders New Jersey Department of Human Services Division of Mental Health & Addiction Services October, 2015 1 Background on Excellence in Mental

More information

PROGRAM DESCRIPTIONS & INFORMATION

PROGRAM DESCRIPTIONS & INFORMATION PROGRAM DESCRIPTIONS & INFORMATION PROGRAM DESCRIPTIONS & INFORMATION All programs are based on recovery and resiliency and strive to identify and support individuals with co-occurring mental health and

More information

General GAP Questions

General GAP Questions General GAP Questions 1. What is GAP? The Governor s Access Plan, known as GAP, is a demonstration program offering a targeted benefit package for up to 20,000 Virginians who have income less than 100%

More information

Section 6. Medical Management Program

Section 6. Medical Management Program Section 6. Medical Management Program Introduction Molina Healthcare maintains a medical management program to ensure patient safety as well as detect and prevent fraud, waste and abuse in its programs.

More information

other caregivers. A beneficiary may receive one diagnostic assessment per year without any additional authorization.

other caregivers. A beneficiary may receive one diagnostic assessment per year without any additional authorization. 4.b.(8) Diagnostic, Screening, Treatment, Preventive and Rehabilitative Services (continued) Attachment 3.1-A.1 Page 7c.2 (a) Psychotherapy Services: For the complete description of the service providers,

More information

NORTH COUNTRY COMMUNITY MENTAL HEALTH NORTHERN AFFILIATION UTILIZATION MANAGEMENT PLAN November 1, 2001. Revised January 2013

NORTH COUNTRY COMMUNITY MENTAL HEALTH NORTHERN AFFILIATION UTILIZATION MANAGEMENT PLAN November 1, 2001. Revised January 2013 NORTH COUNTRY COMMUNITY MENTAL HEALTH NORTHERN AFFILIATION UTILIZATION MANAGEMENT PLAN November 1, 2001 Revised January 2013 I. Mission II. III. IV. Scope Philosophy Authority V. Utilization Management

More information

IRG/APS Healthcare Utilization Management Guidelines for West Virginia Health Homes - Bipolar and Hepatitis

IRG/APS Healthcare Utilization Management Guidelines for West Virginia Health Homes - Bipolar and Hepatitis IRG/APS Healthcare Utilization Management Guidelines for West Virginia Health Homes - Bipolar and Hepatitis CHANGE LOG Medicaid Chapter Policy # Effective Date Chapter 535 Health Homes 535.1 Bipolar and

More information

COMMUNITY MENTAL HEALTH RESOURCES

COMMUNITY MENTAL HEALTH RESOURCES COMMUNITY MENTAL HEALTH RESOURCES (Adult Mental Health Initiative) Ramsey & Washington Information gathered by: MN. State Advisory Council on Mental Health 17-25 Year Old Committee Mental Health Services

More information

STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION REQUEST FOR INFORMATION 09/10-RFI-003

STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION REQUEST FOR INFORMATION 09/10-RFI-003 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION REQUEST FOR INFORMATION 09/10-RFI-003 Statewide Inpatient Psychiatric Program for Individuals Under the Age of Eighteen PURPOSE The State of Florida,

More information

August 2014. SutterSelect Administrative Manual

August 2014. SutterSelect Administrative Manual August 2014 SutterSelect Administrative Manual Introduction This SutterSelect Administrative Manual has been prepared as a resource for providers who are caring for members of SutterSelect health plans.

More information

FAQ#1 * Updated for November 2014 Behavioral Health Administrative Services Organization Transition

FAQ#1 * Updated for November 2014 Behavioral Health Administrative Services Organization Transition FAQ#1 * Updated for November 2014 Behavioral Health Administrative Services Organization Transition Provider Enrollment and Registration How will providers register with the Administrative Services Organization

More information

OUTPATIENT SERVICES. Components of Service

OUTPATIENT SERVICES. Components of Service OUTPATIENT SERVICES Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance specifications. Additionally, providers contracted

More information

KANSAS MENTAL HEALTH COALITION An Organization Dedicated to Improving the Lives of Kansans with Mental Illnesses

KANSAS MENTAL HEALTH COALITION An Organization Dedicated to Improving the Lives of Kansans with Mental Illnesses KANSAS MENTAL HEALTH COALITION An Organization Dedicated to Improving the Lives of Kansans with Mental Illnesses Testimony presented to the Senate Subcommittee on the Kansas Department on Aging and Disability

More information

QUICK START GUIDE EDI Claims Link for Windows version 3.1

QUICK START GUIDE EDI Claims Link for Windows version 3.1 QUICK START GUIDE EDI Claims Link for Windows version 3.1 System Requirements - Operating system: Windows 98 or later - Computer/Processor: Pentium 2, 233 MHz or greater - Memory: 64MB Ram - Initial application

More information

Nursing Home Facility Implementation Overview

Nursing Home Facility Implementation Overview DrConnect Improved Communication; Improved Care Nursing Home Facility Implementation Overview clevelandclinic.org/drconnect Cleveland Clinic 1995-2013. All Rights Reserved. Table of Contents Table of Contents...2

More information

5.5 Mobile Treatment Services (MTS)/Assertive Community Treatment (ACT)

5.5 Mobile Treatment Services (MTS)/Assertive Community Treatment (ACT) 5.5 Mobile Treatment Services (MTS)/Assertive Community Treatment (ACT) Service Coverage Mobile Treatment Services are community-based, intensive, outpatient services rendered by providers approved under

More information