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Managing

integrated healthcare

with a conscience.

PM Section 13.0 FORMS AND ATTACHMENTS

 

NARBHA PROVIDER MANUAL

 

Section 3.1 Eligibility Screening for AHCCCS Health Insurance Medicare Part D Prescription Drug Coverage

Section 3.3 Referral Process

Section 3.5 Third Party Liability and Coordination of Benefits

Section 3.6  Member Handbooks

Section 3.9 Intake, Assessment and Service Planning

Section 3.10 SMI Eligibility Determination

Section 3.11 General and Informed Consent to Treatment

Section 3.13 Covered Behavioral Health Services

Section 3.14 Securing Services and Prior Authorization

Section 3.15 Psychotropic Medications: Prescribing and Monitoring   

3.16 Medication Formulary

Section 3.18 Pre-Petition Screening, Court-Ordered Evaluation and Court-Ordered Treatment

Section 3.19 Special Populations

Section 3.20 Credentialing and Privileging

Section 3.22 Out-of-Sate Placements for Children and Young Adults

Section 3.23 Cultural Competence

Section 3.27 Verification of U.S. Citizenship or Lawful Presence for Public Behavioral Health Benefits

Section 3.28 Quality of Care Concerns

Section 4.2 Behavioral Health Medical Record Standards

Section 4.3 Coordination of Care with AHCCCS Health Plans and PCPs

Section 4.4 Coordination of Care with Other Government Entities

Section 5.1 Member Notice Requirements

Section 5.3 Grievance and Request for Investigation for Persons Determined to Have a Serious Mental Illness (SMI)

Section 5.4 Special Assistance for SMI Members

Section 5.5 Notice and Appeal Requirements (SMI and Non-SMI/Non Title XIX/XXI)

Section 6.2 Submitting Claims and Encounters

Section 7.2 Medical Institution Reporting for Medicare Part D

Section 7.3 Seclusion and Restraint Reporting for Level I Facilities

Section 7.4 Reporting of Incidents, Accidents and Deaths

Section 7.5 Enrollment, Disenrollment and other Data Submission

Section 7.10 Showing Report

Section 8.5 MCE Studies

Section 9.1 Training and Development

Section 10.1 Financial Management

Section 10.7 Sentinel Events

Section 10.13 Provider Compliance Programs for Fraud and Abuse

 Section 10.16 Move-In Assistance and Community Tenure Support Program

Section 10.17 Member Choice and Transfers between Providers

Section 10.21 Peer Review

ADHS/DBHS Medication List

Single Case Agreement Contract Request Form

Instructions for RA Single Case Agreement Request Form