Insurance, YAY
___ is the RBHA in Maricopa County
What is Mercy Care?
SMI AND SED
What is Severe Mental Illness?
What is Severe Emotional Disturbance?
Staff should respond to and return calls, emails, etc. withing ______
What is 24 business hours?
Clinical documentation needs to be input/complete within ______
What is 24 hours?
____, ____, and ____ are 3 examples of Social Determinants of Health
What is socioeconomic status, education, healthcare access/quality, community, social support, legal/social welfare?
___, ___ & ____ are three examples of DSP's
What are SWN, SB&H, Lifewell, La Frontera-Empact, Jewish Family, AZCA, AZYFS, Touchstone, Terros Health and Valle Del Sol? (other answers accepted)
DSP
What is Direct Service Provider?
How long do staff have to complete a documented outreach when assigned a new patient? (2 answers)
- 48 hours for level 2/moderate risk
- 24 hours for level 3/high risk
What needs to be in the patient chart in order to use/bill a certain billing code?
What is the billing code must be on the ISP attached to a treatment goal?
______ is the form clinicians use with patients to determine SDOH needs
What is the PRAPARE?
What do staff need to get approved by insurance to obtain a higher level of care such as a BHIF/BHRF?
What is a Prior Authorization?
SDOH
What is Social Determinant of Health?
What is 24 hours?
ISPs, Crisis Plans, and Comprehensive Assessments need to be signed off by a BHP within _____
What is 72 hours?
What is the age that Mercy Care says that Transition Planning needs to START?
What is 14 YO?
What does insurance require when a patient is discharged from the hospital?
What is a follow up BHMP appt within 7 days, follow up therapy appt within 7 days, and post discharge CFT?
NTP
What is Notice to Provider
-adding/removing services from ISP
- crisis situation/hospitalization
- change in risk level/level of care
- change in engagement
- discharge/closure/transfer
- DCS/other agency involvement
Aside from the 8 minute rule, what is the biggest difference between a BILLABLE and NON BILLABLE note?
What is, billable notes actively moves treatment forward?
What are 3 examples of providing cultural competent care?
- language line/jeenie for interpretation/translation
- considering social identity and impacts on treatment (gender, orientation, ability/disability)
- other examples accepted
What does RBHA stand for?
What is Regional Behavioral Health Authority?
AHCCCS
What are the 4 levels of care (4 risk levels with definitions)?
LEVEL 0 - For all patients on private insurance, SFS (sliding fee scale), and/or is psych/pcp only
LEVEL 1 Open in BH, Low Risk -Full BH intake was completed – need identified for low intensity services such as GMH PCC, medication management, and/or support coaching/TAY
LEVEL 2 Open in BH, Moderate Risk - Full BH intake was completed - Client generally engaged with PCC for case management, therapy, and/or med management -Indicates that the client requires support with attending appointments with need for frequency contact/CFTs to assess treatment goals/resources
LEVEL 3 Open in BH, High Risk - Full BH intake was completed – client identified as high risk due to factors such as SI/HI, DTS/DTO, recent hospitalizations, engaging in risky behaviors, substance use, legal involvement, sexually concerning bx, impulsive bx, social determinant concerns (homelessness, unemployment, etc.), diagnosis requiring higher level of care, other agency involvement (DCS, DDD, DES), and more. Generally engaged with PCC and/or other intensive outpatient services.
What is the process to verify or add insurance to a patient chart?
What is send NG task to eligibility from the chart?
What platform do staff use to connect patients with non behavioral health resource needs?
What is Unite Us/Community Cares?