Provider Attestation (Expedited Requests Only) Clinical justification for expedited review:



Similar documents
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT

REFERRAL INFORMATION CHILD, YOUTH AND FAMILY PROGRAM

North Bay Regional Health Centre

Mental Disorders (Except initial PTSD and Eating Disorders) Examination

Mental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault

Psychiatric Residential Treatment Facility Referral

Arrive 15 minutes before your scheduled appointment time.

Preadmission Screening. Who Is Subject to PASRR Screens. Who can Complete the ACH PASRR Level I Screen. Getting Help

Intake Form. Marital Status: Date of Birth: Street Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Social Security #:

AmeriHealth Caritas District of Columbia Psychiatric Residential Treatment Facility Referral

CRITERIA CHECKLIST. Serious Mental Illness (SMI)

SPOUSE / PARTNER ONE TO COMPLETE THIS SECTION SEPARATELY. Name: (Last) (First) (Middle Initial)

Behavioral Health Consulting Services, LLC

PSYCHIATRIC INFORMATION: Currently in treatment? Yes No If no, what is barrier to treatment: Clinical Treatment Agency:

Elizabeth A. Crocco, MD Assistant Clinical Professor Chief, Division of Geriatric Psychiatry Department of Psychiatry and Behavioral Sciences Miller

ENTITLEMENT ELIGIBILITY GUIDELINE

Adult Information Form Page 1

Initial Evaluation for Post-Traumatic Stress Disorder Examination

Mental Health, Disability and Work: Inpatient Medical Rehabilitation

Personality Disorders

Washington State Regional Support Network (RSN)

F43.22 Adjustment disorder with mixed anxiety and depressed mood Adjustment disorder with disturbance of conduct

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top

Co-Occurring Disorders: A Basic Overview

SUBSTANCE ABUSE OUTPATIENT SERVICES

Wake Forest Mind and Health, PLLC 501 North Main Street Wake Forest, NC 27587

Anti-Social Personality Disorder

Behavioral Health Medical Necessity Criteria

Brief Review of Common Mental Illnesses and Treatment

B i p o l a r D i s o r d e r

EXHIBIT D, COVERED BEHAVIORAL HEALTH DIAGNOSES

Drugs PSYCHOSIS. Depression. Stress Medical Illness. Mania. Schizophrenia

James A. Purvis, Ph.D. Psychotherapy Services Agreement

Behavioral Health Medical Necessity Criteria

REFERRAL FORM FOR ADMISSION TO HOMEWOOD HEALTH CENTRE

INSTRUCTIONS FOR FORM PCF05: PSYCHIATRIC/SUBSTANCE ABUSE EXTENSION OR RECONSIDERATION. NOTE: Fields 1 6 MUST be filled in

Behavioral Health Medical Necessity Criteria

General Information. Age: Date of Birth: Gender (circle one) Male Female. Address: City: State: Zip Code: Telephone Numbers: (day) (evening)

Santa Fe Sage Counseling Center

Mental Health Ombudsman Training Manual. Advocacy and the Adult Home Resident. Module V: Substance Abuse and Common Mental Health Disorders

TREATING MAJOR DEPRESSIVE DISORDER

Welcome New Employees. Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders

INPATIENT SERVICES. Inpatient Mental Health Services (Adult/Child/Adolescent)

Feeling Moody? Major Depressive. Disorder. Is it just a bad mood or is it a disorder? Mood Disorders. S Eclairer

How to Recognize Depression and Its Related Mood and Emotional Disorders

Inpatient Behavioral Health and Inpatient Substance Abuse Treatment: Aligning Care Efficiencies with Effective Treatment

TELEMEDICINE SERVICES Brant Haldimand Norfolk INITIAL MENTAL HEALTH ASSESSMENT NAME: I.D. # D.O.B. REASON FOR REFERRAL:

Provider Training Series The Search for Compliance. Outpatient Psychiatric Services February 25, 2014 Melissa Hooks, Director of Program Integrity

ICD- 9 Source Description ICD- 10 Source Description

Attachment 5 Arizona s Crosswalk for DC: 0-3R, DSM-IV-TR and ICD-10-CM 1

[KQ 804] FEBRUARY 2007 Sub. Code: 9105

CHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March MVP Health Care, Inc.

Austen Riggs Center Patient Demographics

Depression Assessment & Treatment

Managed Health Care Administration Initial Assessment Child/Adolescent Program Parent Questionnaire Page 1

Instructions for SPA Paper Application

Applied Behavioral Analysis Treatment Report Initial Authorization Request

Maryland Medicaid HealthChoice Substance Use Disorder Form Instructions

How To Know If You Should Be Treated

SCREENING FOR INTIMATE PARTNER VIOLENCE IN THE PRIMARY CARE SETTING

D. Clinical indicators for psychiatric evaluation are established by one or more of the following criteria. The consumer is:

Psychiatric Comorbidity in Methamphetamine-Dependent Patients

Intensive Residential Treatment Services -IRTS. Program Description

Traumatic Stress. and Substance Use Problems

-- No equivalent DSM-IV code disorders 303 Alcohol dependence syndrome -- No equivalent DSM-IV code [0-3]*

OK to leave Messages?

Psychiatric Residential Treatment Facility (PRTF): Aligning Care Efficiencies with Effective Treatment. BHM Healthcare Solutions

Grapevine Behavioral Healthcare Associates 2311 Mustang Dr #300, Grapevine, TX Office (817) Fax (817)

OUTPATIENT DAY SERVICES

Alcohol Use Scale-Revised {AUS-R)

GENDER SENSITIVE REHABILITATION SERVICES FOR WOMEN A workshop

PARTNERS IN PEDIATRIC CARE. Intake and History for Mental Health Referral

Dual Diagnosis Nursing Care: Treating the Patient with Co-Occurring Addiction & Mental Health Disorders. Deborah Koivula R.N.

Diagnosis Codes Requiring PASRR Level II_ xls

Alcohol and Drug Abuse Treatment Centers

Depression in the Elderly: Recognition, Diagnosis, and Treatment

BOARD OF PHARMACY SPECIALITIES 2215 Constitution Avenue, NW Washington, DC FAX

Provider Notice May 30, Pre-Authorization 1915(b) Service

When You Are More Than Down in the Dumps Depression in Older Adults

PACKET OVERVIEW TABLE OF CONTENTS

Suicide Screening Tool for School Counselors

Texas Foster Care Outpatient Treatment Requests (OTRs)

Maryland Medicaid HealthChoice Use Form Instructions

DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource

SECTION VII: Behavioral Health Services

Medical Necessity Criteria

Michael Brennan, MA, LMHC Providence St. Peter Hospital Crisis Services

prodromal premorbid schizophrenia residual what are the four phases of schizophrenia describe the Prodromal phase of schizophrenia

Chapter 18 Behavioral Health Services

PSYCHIATRIC EMERGENCY. Department of Psychiatry Pomeranian Medical University in Szczecin

CHAPTER 6 Diagnosing and Identifying the Need for Trauma Treatment

Identifying Individuals with a Dual Diagnosis and Substance Misuse

CO-OCCURRING DISORDERS. Michaelene Spence MA LADC 8/8/12

Does Non-Suicidal Self-injury Mean Developing Borderline Personality Disorder? Dr Paul Wilkinson University of Cambridge

Transcription:

Inpatient Treatment Request Fax completed form to: 866 949 4846 Fill out completely to avoid delays Date: / / Request Type (Check one): Standard Expedited (additional information required below) Provider Attestation (Expedited Requests Only) Clinical justification for expedited review: By signing below, I certify that applying the standard review timeframe for this service request may seriously jeopardize the life or health of the patient or the patient s ability to regain maximum function. Physician/clinician name: Signature: Identifying Data First: Middle: Last: Health Plan ID: Date of Birth: / / Gender: Male Female Address: State: Zip: Provider Information Provider name: NPI#: Phone: ( ) Fax: ( ) Other Current BH Provider(s) Check one: Member agreed to release of information to their PCP and/or other treating providers dated. Member has been informed for release of information and has declined. Diagnoses Axis I Axis V Axis II Axis IV Axis III Highest GAF in past year:

Psychotropic Medications Medication Previous or current? Changed since last report? Dosage Frequency Adherent? Clinical Information Check all that apply Persistent Persistent Anxiety Disorders Obsessions/compulsions Generalized Anxiety Panic Attacks Phobias Somatic complaints PTSD symptoms Depression Impaired concentration Impaired memory Psychomotor retardation Sexual issues Appetite disturbance Irritability Agitation Sleep disturbance Hopelessness/Helplessness Mania/Hypomania Insomnia Grandiosity Pressured Speech Racing thoughts/flight of ideas Poor judgment/impulsivity Sexual preoccupation Psychotic Disorders Delusions/paranoia Self care deficits Hallucinations, Type: Responding to Internal Stimuli Disorganized thought process Loose associations Substance Use Disorder Loss of control of dosage Amnesic episodes Legal problems Alcohol abuse Opiate abuse Prescription medication abuse Polysubstance abuse Personality Disorder Oddness/eccentricities Oppositional Disregard for law Recurring self injuries Sense of entitlement Passive aggressive Dependency Manipulation Page 2 of 5

Co occurring Medical Conditions Chronic Chronic Risk Factors Check all that apply Risk Factors None Ideation with plan Ideation without plan Intent with means Intent without means Current? Suicide Homicide Abuse None Victim Patient is Perpetrator Does abuse or neglect involve a child or elder? Abuse has been legally reported Current? Physical Sexual Family/Interpersonal relationships Barriers / Risk Factors Social History (Last 3 years if known) Current or Current Supports/Protective Factors Job/School Housing Family History of Mental Illness / Substance Use Disorder Page 3 of 5

Treatment History Level of Care Inpatient psychiatric Inpatient Substance Use Disorder Partial Hospitalization (PHP) # of distinct episodes/ sessions Date of last treatment All levels of care Level of Care Intensive Outpatient (IOP) Outpatient psych (individual or group) Outpatient substance abuse (individual or group) # of distinct episodes/ sessions Date of last treatment Treatment Goals 1. Treatment Goals and Outcomes Complete fields below and/or attach current treatment plan 2. 3. Objective outcome criteria by which goal will be measured: 1. 2. 3. Expected Outcome and Prognosis (check all that apply) Return to normal functioning Expected improvement, anticipated less than baseline functioning Relieve acute symptoms, return to baseline functioning Maintain current status, prevent deterioration Discharge/Termination Plan (include estimated discharge date) Page 4 of 5

Requested Authorizations Service 1 Code # Units requested Service Start Date Service End Date 2 3 Requested by: Phone: Fax: Fax completed form to: 866 949 4846 Fill out completely to avoid delays Page 5 of 5