Choose font size:  A A A
 

Managing

behavioral healthcare

with a conscience.

PM Section 13.0 FORMS AND ATTACHMENTS

  

Arizona Department of Health Services          

Division of Behavioral Health Services

PROVIDER MANUAL

NARBHA Edition

Section 13.0 FORMS AND ATTACHMENTS

 

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

Section 3.3 Referral Process

Section 3.4 Co-Payments

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

3.16 Medication Formulary

Section 3.17 Transition of Persons

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 3.21 Service Prioritization for Non-Title XIX/XXI Funding

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 3-9 Intake, Assessment and Service Planning

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 5.6 Provider Claims Disputes

Section 6.1 Submitting Claims and Encounters

Section 7.1 Fraud and Abuse Reporting

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 8.5 MCE Studies

 

Section 9.1 Training and Development

 

Section 10.1 Financial Management

 

Section 10.2 Environment of Care and Infection Control

Section 10.3 Care Delivery

Section 10.7 Sentinel Events

Section 10.9 HIPAA Joing NARBHA/SAA/TAA Privacy Notice

 

 Section 10.16 Move-In Assistance and Community Tenure Support Program

Section 10.17 Member Choice and Transfers between Providers