PRIOR AUTHORIZATION MANUAL - odmhsas.org

levels of care and specialized services 29 medical necessity criteria 31 client assessment record 54 addiction severity index (asi) 67 customer data core (cdc) 69

FY2015 BEHAVIORAL HEALTH CASE MANAGEMENT GUIDE

The information in this guide is considered to be supplemental to OHCA’s and ODMHSAS’s rules for Behavioral Health Case Management. This information is intended to assist with the provision and documentation of Case Management services. INTRODUCTION Behavioral Health Case Management (BHCM) is an ancillary service provided in

  Health, Guide

Client Assessment Record 2010 - Oklahoma …

CLIENT ASSESSMENT RECORD (CAR) GENERAL INFORMATION The purpose of the Client Assessment Record (CAR) is to give clinicians a tool to evaluate the

  Assessment, Record, Clients, Client assessment record

Management Report, Executive Summary

Management Report, Executive Summary 3 Central Oklahoma Community Mental Health Center | Executive Summary Specialized Training in Fiscal Year 2011

  Report, Center, Management, Summary, Executive, Executive summary, Management report

Training for Letters of Collaboration (LOC) and ...

Training for Letters of Collaboration (LOC) and Termination (LOT) for Medicaid and ODMHSAS Outpatient Behavioral Health Providers (OPBH) With Changes Effective 10/1/2014

  Health, Behavioral, Provider, Outpatient, Odmhsas outpatient behavioral health providers, Odmhsas, Opbh

Federal grant terminology. However, some private ...

Grant Terminology 1 In the following list, several grant terms are specific to Federal Grants, as indicated by double astricks ( **) following the term.

  Federal, Terminology, Grants, General draft

Addiction Severity Index Handouts

At this point the interviewer makes a preliminary rating, a 2-3 point range - based only on objective items. 2. Interviewer looks at subjective items and fine tunes his rating to a single score. **** REMEMBER We are not rating potential benefit but the extent to which treatment is needed (regardless of availability or potential efficacy).

  Preliminary

Adverse Childhood Experience (ACE) Questionnaire

Adverse Childhood Experience (ACE) Questionnaire Name: _____ Date: _____ This Questionnaire will be asking you some questions about events that happened during your childhood; specifically the first 18 years of your life. The information you provide by answering these questions will allow us to better understand problems that may have occurred ...

  Questionnaire, Childhood, Experience, Adverse, Adverse childhood experiences

Request for Services Requiring Pre Authorization

Member Name: Member ID #: Member DOB: / / Telephone: ( ) PCP Name: PCP ID #: Telephone: ( ) Referring Physician Name:

  Services, Request, Authorization, Requiring, Request for services requiring pre authorization

PLEASE READ CAREFULLY THE FOLLOWING …

The undersigned requests written authorization for the following special service(s) costing over $1,000 or requiring pre-authorization pursuant to the Medical Treatment Guidelines.Do NOT use this form for injuries/illnesses involving the Mid and Low Back, Neck, Knee, Shoulder, Carpal Tunnel Syndrome and Non-Acute Pain, except for the …

  Authorization, Requiring, Requiring pre

Provider Guide for Prime Healthcare EPO

Revised: 01282013 Page 5 The Referral Process is provider-driven for all in-network care. The provider is responsible to obtain authorization for an inpatient admission, specialist visits, or any outpatient services requiring a referral.

  Services, Guide, Provider, Authorization, Healthcare, Prime, Requiring, Provider guide for prime healthcare epo, Services requiring

Provider Manual Section 5.0 Utilization Management

Page 6 of 8 DME items with billable charges greater than $500 require an authorization. Requests for authorization of purchase MUST be received PRIOR to …

  Manual, Management, Section, Provider, Authorization, Utilization, Provider manual section 5, 0 utilization management

Clinical Coverage Policy 3L, Personal Care Services …

THE STATE OF NORTH CAROLINA Department of Health and Human Services Clinical Coverage Policy 3L, Personal Care Services (PCS) Benefit Program

  Policy, Services, Clinical, Benefits, Care, Personal, Coverage, Clinical coverage policy 3l, Personal care services, Services clinical coverage policy 3l

Summary of Benefits and Coverage: What this Plan …

The 6 of 6 plan would be responsible for the other costs of these EXAMPLE covered services. Peg is Having a Baby (9 months of in-network pre-natal care and a hospital delivery) Mia’s Simple Fracture (in-network emergency room visit and follow

  Services

Miami-Dade County Emergency and Evacuation …

The Emergency and Evacuation Assistance Program (EEAP) is designed for individuals living at home that need assistance with evacuation and sheltering.

  Programs, Miami dade, Miami, Dade, Emergency, Assistance, Evacuation, Emergency and evacuation assistance program