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Last Revision Effective Date: |
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1.0 |
Scope |
8/15/07 |
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2.0 |
Introduction |
8/15/07 |
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3.0 |
Clinical Operations |
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3.1 |
Eligibility Screening for AHCCCS Health Insurance, Medicare Part D
Prescription Drug Coverage, and the Limited Income Subsidy Program |
10/15/08 |
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3.2 |
Appointment Standards and Timeliness of Service |
3/15/08 |
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3.3 |
Referral and Intake Process |
7/1/09 |
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3.4 |
Co-payments |
5/1/08 |
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3.5 |
Third Party Liability and Coordination of Benefits |
6/1/06 |
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3.6 |
Member Handbooks
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3/1/09 |
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3.7 |
Clinical Liaison |
1/1/07 |
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3.8 |
Outreach, Engagement, Re-Engagement and Closure
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9/15/08 |
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3.9 |
Intake, Assessment and Service Planning |
1/1/06 |
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3.10 |
SMI Eligibility Determination |
7/1/05 |
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3.11 |
General and Informed Consent to Treatment |
2/1/09 |
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3.12 |
Advance Directives |
2/1/09 |
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3.13 |
Covered Behavioral Health Services |
09/15/09 |
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3.14 |
Securing Services and Prior Authorization |
8/1/07 |
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3.15 |
Psychotropic Medications: Prescribing and Monitoring
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8/15/07 |
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3.16 |
Medication Formulary |
5/15/08 |
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3.17 |
Transition of Persons |
12/15/04 |
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3.18 |
Pre-petition Screening, Court Ordered Evaluation and Treatment |
8/1/05 |
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3.19 |
Special Populations |
04/01/09 |
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3.20 |
Credentialing and Privileging |
4/15/05 |
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3.21 |
Service Prioritization for Non-Title XIX/XXI Funding |
12/15/08 |
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3.22 |
Out-of-State Placements for Children and Young Adults |
6/1/08 |
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3.23 |
Cultural Competence |
3/1/08 |
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4.0 |
COMMUNICATION AND CARE COORDINATION |
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4.1 |
Disclosure of Behavioral Health Information |
3/1/09 |
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4.2 |
Behavioral Health Medical Record Standards |
10/1/06 |
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4.3 |
Coordination of Care with AHCCCS Health Plans, Primary Care Providers
and Medicare Providers |
12/1/07 |
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4.4 |
Coordination of Care with Other Governmental Entities |
7/01/09 |
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5.0 |
MEMBER RIGHTS AND PROVIDER Claims Disputes |
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5.1 |
Notice Requirements and Appeal Process for Title XIX and Title XXI
Eligible Persons |
9/15/08 |
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5.2 |
Member Complaints |
8/1/04 |
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5.3 |
Grievance and Requests for Investigations for Persons Determined to have
a Serious Mental Illness |
7/01/09 |
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5.4 |
Special Assistance for Persons Determined to have a Serious Mental Illness |
7/01/09 |
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5.5 |
Notice and Appeal Requirements (SMI and Non-SMI/Non-Title XIX/XXI)
|
9/15/08 |
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5.6 |
Provider Claims Disputes
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09/15/09 |
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6.0 |
DATA AND BILLING REQUIREMENTS |
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6.1 |
Submitting Tribal Fee-for-Service Claims to AHCCCS |
4/15/08 |
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6.2 |
Submitting Claims and Encounters to the RBHA |
4/15/08 |
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7.0 |
REPORTING REQUIREMENTS |
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7.1 |
Fraud and Program Abuse Reporting |
8/15/08 |
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7.2 |
Medical Institution Reporting for Medicare Part D |
8/15/08 |
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7.3 |
Seclusion and Restraint Reporting |
09/15/09 |
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7.4 |
Reporting of Incidents, Accidents and Deaths |
7/1/07 |
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7.5 |
Enrollment, Disenrollment and Other Data Submission
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4/1/08 |
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7.6
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Duty to Report Abuse, Neglect or Exploitation |
12/15/08 |
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8.0 |
PERIODIC AUDITS AND SURVEYS |
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8.1 |
Encounter Validation Studies |
7/01/09 |
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8.2 |
Reserved |
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8.3 |
Behavioral Health Recipient Satisfaction Survey |
12/15/08 |
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8.4 |
Performance Improvement Projects |
09/15/09 |
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8.5 |
Medical Care Evaluation Studies |
5/1/06 |
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9.0 |
TRAINING AND DEVELOPMENT |
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9.1 |
Training Requirements |
7/15/07 |
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10.0 |
T/RBHA SPECIFIC REQUIREMENTS |
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11.0 |
DEFINITIONS |
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12.0 |
FACT SHEETS (under construction) |
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13.0 |
FORMS AND ATTACHMENTS |
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14.0 |
INDEX
[PDF 465K] |
4/15/08 |
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