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Screening, Triage, and Registration

Screening, Triage, and Registration. Forms, Timelines, and WHN procedures. What’s the difference?. Registration vs. Opening Dual funded Consumers. STR Form Review. STR Form Page #2. Description of Clinical Issues Form. PCP Admission Form Review. IPRS Worksheet Review.

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Screening, Triage, and Registration

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  1. Screening, Triage, and Registration Forms, Timelines, and WHN procedures

  2. What’s the difference? • Registration vs. Opening • Dual funded Consumers

  3. STR Form Review

  4. STR Form Page #2

  5. Description of Clinical Issues Form

  6. PCP Admission Form Review

  7. IPRS Worksheet Review

  8. Consumer Consent Form

  9. Medicaid Consumer - Registration Only - Entering the system through WH Access telephone screening • WH Access completes the screening and sends it to the provider chosen by the consumer. • The provider must fax the following forms to WH Medical Records at (828) 225-2779 within 5 working days of initial contact with the consumer. • STR Form – “Registration Only” sections (A-J, 1, and 49-55)

  10. Medicaid Consumer - “No Wrong Door” - STR completed by the provider The provider must fax the following forms to WH Medical Records at (828) 225-2779 within 5 working days of initial contact with the consumer. Failure to register a Medicaid consumer may jeopardize reimbursement. • STR Form complete in full • “Description of Consumer Clinical Issues” form (complete sections A and B) • WHN Consumer Consent Form ( if needed)

  11. Medicaid Consumer - “No Wrong Door” - STR completed by provider with request for H Code authorization (Provisionally Licensed Therapist) To register a Medicaid consumer and seek authorization for services billed through the LME, the following forms must be faxed to Access at (828) 225-2782 within 5 working days. • STR Form - completed in full • “Description of Consumer Clinical Issues” form (complete A,B and C) • PCP Consumer Admission Form • WHN Consumer Consent Form ( if needed) • IPRS Worksheet (only if requesting State funds)

  12. State Funded (IPRS) Consumers – “No Wrong Door”, STR completed by the provider To open the consumer’s case in the WH system and request authorizations for State funded services the provider must fax the following forms to Access at (828) 225-2782 within 5 working days of initial contact. • STR Form – completed in full • “Description of Consumer Clinical Issues” form (complete sections A, B and C) • IPRS Worksheet (only required for case opening) • PCP Consumer Admission Form • WHN Consumer Consent Form ( if needed)

  13. State Funded (IPRS) Consumers –”No Wrong Door”- Face to face assessment for consumers who do not meet any Target Pop criteria To request authorization for state funded services when NOT opening the case, the provider must fax the following forms to Access at (828) 225-2782 within 5 working days. • STR Form - completed in full • “Description of Consumer Clinical Issues” form (complete sections A ,B and C) • PCP Consumer Admission Form

  14. State Funded (IPRS) Consumer - STR completed by WH Access WHN Access will send screening and initial authorization to provider. Provider sends: • PCP Admission Form • IPRS Worksheet • WHN Consumer Consent Form • fax to 225-2779 • Provider requests further authorizations via WHN Service Management

  15. State Funded (IPRS) Consumer - STR completed by WH Access and does not meet Target pop • Return only the “Description of Consumer Clinical Issues” form (complete sections A ,B and C) • fax to 225-2782

  16. Incomplete or incorrect forms? • WHN will pend incomplete forms and administratively deny if not corrected within 14 days .

  17. STR Frequently Asked Questions • Q: What is the Western Highlands Facility Code (Question D)? • A: 13131 • Q: What about the ICD 9 diagnosis code (#18 on the PCP form)? • A: The diagnosis codes in ICD 9 and in DSM-IV are almost all the same, so using the DSM-IV code is OK. • Q: What do I put in the H. IPRS Provider Number boxes? • A: Your license number (LCSW, LPC, LMFT, etc.) or your agency provider number. • Q: What about I. National Provider Identifier? • A: You can obtain this identifier via the following website: https://nppes.cms.hhs.gov • Q: How do I complete #43 Consumer Unique Identifier? • A: Western Highlands will enter this identifier.

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