Terminology
What is BID?
Twice a day
Once a completed CBE is received when must a determination be made?
Within 2 business days
What is the level of care for Project Transition?
Adult Mental Health Residential (AMHR)
When a residential member is admitted to AIP, when should an info share be completed with the hospital reviewer?
Within 24 hours
What should be included in a doc consult?
Member name
CBH ID
Current LOC
Current Provider
Requested LOC
CCM Recommendations
What is QID?
Four times a day
What time are insufficient and denial letters due in MCO to be mailed out on the that day?
3pm sharp
What programs have Residential Treatment Facilities for Adults?
New Vitae
Gaudenzia
Horizon House
Be Well Center
When should a discharge review be completed?
Within 24 hours of discharge
Where are Quality Issues documented in MCO?
Under General Docs - Quality Issue
What is QHS?
Bedtime
One day
Community Treatment Team - Clinically Supportive Living has which programs?
New Vitae in Quakertown
PaHrtners
When must peer to peer requests be made?
Providers have 24 hours to request a peer-to-peer review (see bottom of ONF)
Where are residential referrals sent for processing?
AdultResidentialReferrals@phila.gov
What is TID?
Three times a day
After the CBE is approved by the Physician Advisor, how many days of residential treatment are approved and sent in the outcome notification?
An initial 15 days
After a member has returned to a residential placement following an AIP admission, the residential provider should provide a follow-up within how many days?
7 days - document in MCO using the ACBS care coordination note
For a concurrent review, when must a determination be made?
Within 1 business day of the receipt of all supporting documentation for nonurgent levels of care
Enhanced staffing requests must be taken to a Physician Advisor for approval. What are the three enhanced staffing requests?
1:1 staffing
2:1 staffing
Private room requests
What is QD?
Every day
What are the timeframes for tiered care management?
30, 60 and 90 day authorizations
What are the names of the three Long Term Structured Residences (LTSR)?
Westhaven
Independence House
York Street
A CBE can be accepted if it has been completed within what timeframe?
6 months
What should be done to send emails outside of CBH with a member's protected health information (i.e. name, DOB, SSN, diagnosis, etc.)?
Encryption