886 0 obj The Behavioral Health Home shall submit the SMI evaluation packet within seven days of the Urgent Engagement assessment to the designated SMI Evaluation provider, Community Response Network (CRN). CDR notifies BH provider. Provider Manual; Provider Alerts; Provider Newsletter; Provider Representatives; Incident Reporting; FWA Compliance; UPMC Health Plan Behavioral Health Services; Secure Sites. ��+�m� Purpose. Community Behavioral Health Provider Manual | November 19, 2020 | 7 1. The plan offers members and employers an array of health management programs, which support evidence-based approaches to health … 13 2013 QM Program Evaluation: Access to and Availability of Care One way that MBHP measures how well we are doing is These indicators provide the drive for health institutions to do better and to submit timely reports of progress. Evaluation, Therapy and Training. 14.1.2 Capacity to Travel. These set performance standards ensure that the health institution is at par with other high-performing hospitals and medical centers. It is prepared on an annual basis and reviewed for appropriateness twice a … accordance with these standards. Behavioral Health Services Rules and Guidelines; Tools for Oregon Health Plan Providers; Tools for Behavioral Health Providers; Contract Transition. As an extension of the Provider Agreement, this manual describes the policies, �k�!V�\P�k�c��LnI}�X�3��;�ȓoQ��s�S,8���c��$I���������C�A&���&��j�P,9h�. Improve member and provider satisfaction with the health plan services; and 4. ... 2013 QM Program Evaluation: Behavioral Health Provider Satisfaction. Value-Based Behavioral Health Care. The purpose of the Community Behavioral Health (CBH) IBHS Performance Standards is to establish expectations for high-quality IBHS for children, adolescents, young adults, (hereafter often referred to as “youth”), and their families so that they may achieve success So, in this article, we are […] �U��L�Ua������ ��������������Ѡ�������d�0�)FW �ļ`�3�3������F���� ��9�(20:�iN�\ ���r H�00����L� ��>H 887 0 obj Accountability a. INTRODUCTION 1.1. Health Care Service Corporation, Inc. (operating through its five divisions: BCBS of Illinois, BCBS of Montana, BCBS of New Mexico, BCBS of Oklahoma, and BCBS of Texas) Behavioral Health Care Management program has been accredited for Health Utilization Management since October of 2012.This accreditation covers the Behavioral Health Utilization Management program for … Members can also call Healthy Blue at 1-844-227-8350 for help getting specialized behavioral health care. <> eInsight is a web-based data platform developed specifically to meet the needs of behavioral health providers. The Provider Evaluation of Performance (PEP) Plan details the content of the audit processes that will be utilized during a review so that Providers will have a summary of the requirements which may be utilized to review their own performance and implement change. The medical provider will instruct the Soldier to go to the BH station at that location. <> We're working together with Magellan Healthc are to provide our Members with integrated behavioral healthcare solutions. �]j�K���W1��������ă�u�NI�$�2(MJ1 �0������j6[I=���#����W���j�H�M <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 960 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> <>stream After years of development, eInsight now includes the outcomes measures and assessment tools most commonly used in behavioral health organizations. a Performance Improvement Project for Behavioral Health in Managed Care Based on the Principals on QISMC September 2002 Prepared by: Dow Wieman, Ph.D., H. Stephen Leff, Ph.D. Amy DiRamio, Sarah Witham the Evaluation Center@HSRI Eric Goplerud, Ph.D., Elise Young, MSW Substance Abuse and Mental Health Services Administration BH provider recommendations (See box B for minimum recommendations) CDR discusses with BH provider. �;��H�c�k�j�G���U¦�5M-[%Ur�,�|%�a�r��.�#d�4�'y����3>�ݼY �6�vF`DQI�=hϪMÕ#���~�E?&�y�?�p�H��J����~�hكi)I�J �z�>��]EHx�n����4) ��!�����ϲ�P�Y��!ƴ!8'�~�f7@~層u������~��I4����y�������P�6d���h���O:>�t,�R�v�����:�iM4��CǜU�c��8��_�����RWTo�jI�b��P����̀�M�b�$B���E:�zM��DW�zG���"5�1�_F;����uڴIc��~R�dR|QR�tb��긶 �:�A/������ Innersense Behavioral Health provides a full range of therapy and evaluation services to children, adults, couples, and families. MARCH 2016 2 • 5732/1519 performance measurement development process • Measures selected for use with AAAs and BHOs • Measures selected for use in HCA MCO contracting –Mental health service penetration rate –Substance use disorder treatment penetration rate –Psychiatric hospitalization 30-day readmission rate %���� • Behavioral Health Provider Satisfaction ... We are centered on improving performance, building strong leaders, and enhancing organizational effectiveness. <> 2 0 obj In 2015, more than 27 million people in the United States reported that they currently used illicit drugs or misused prescription drugs, and more than 66 million reported binge drinking during the previous month. x��V�k�0�n��p��4E:�� ���[�A�v �1��dvb���qW���d���ҹi��K�{�ݓt�uS�颁�l Starting July 1, 2020, Comagine Health has assumed responsibility for assessments from the current contractor, KEPRO. Public reporting b. Value-based payment A portion of these data are reported in this QM Program Summary. 1 0 obj DEFINITION Community Support Program (CSP) is an array of services delivered by a community-based mobile staff. In considering changes to performance measures and other aspects of the behavioral health system, communication with and input from stakeholders is critical. 4 0 obj 5 0 obj Applicability: When a Soldier is seen by a medical provider during a PHA event and identified to need further evaluation by a Behavioral Health Provider (BHP). endobj specific performance specifications, in addition to the General Behavioral Health Performance specifications. Behavioral Health State Plan Services-Provider Requirements and Reimbursement Manual, which is being released as an informational and educational tool; however, this manual is subject to change and future revisions as the implementation and operations of … All Performance specifications are located online at tuftshealthplan.com in the Provider Resource Center. 904 0 obj 6. }���G���xY�����a~1y�"�l�:��x2_S��lUnR��^���3��^|�ـ�*^!� 2. Below are tips to help improve rates: Follow up after discharge from a behavioral health Document Purpose and Philosophy This manual serves as a guide for providers within the Community Behavioral Health (CBH) network. Through Magellan, we provide a broad, diverse network of experienced behavioral health providers, as well as expert case managers working with AvMed clinical staff to coordinate your patient's care. Behavioral health clinicians, peer support specialists, health care professionals, community agencies interested in supporting behavioral health, consumers and family members will gather to hear about the status of behavioral health in North Dakota and learn from … endstream Provider use of behavioral health clinical practice guidelines For 2018, the QM Program identified goals that were successfully met and areas for improvement. h�bbd``b`z$g�} ��kq��w$�x������ How members access Behavioral Health services. Only qualified professionals that meet our professional standards are included in our contracted provider network. %PDF-1.5 %���� Evaluation of progress toward meeting the QM Program goals is used to stream Y�@��#E��d�1k��=X��_��Z/wE?�4f)G�n�[�1]� rä�a2�_�A=R�(%��{�D�[V behavioral health (BH) and 343 developmental disabilities (DD) providers. Provide an escort for Soldier safety. d100C��� � H�� endobj endobj Providers, our Provider Training webinar was held on Thursday, June 25, 2020. h�b```�tfv>~�g`C�&���Ϙ_00�|dJ�;���L����������*M��;3�v<6�}�̴�Ն�, %%EOF The purpose of the Healthcare Provider’s Practice Guide for the Utilization of Behavioral Health Technicians. Process Steps: a. Outcomes Evaluation Efforts to evaluate the effectiveness of California’s behavioral health services are sorely lacking in infrastructure and investment. During surveys of both psychiatric hospitals and behavioral health organizations, issues continue to arise around how the organization is assessing the competence of its clinical staff. If a Healthy Blue member is dealing with depression, anxiety or a mental health concern, our care managers will work with the member and their primary care provider to help get the care they need. x���=kd���o���ܥ�ƽ�KcT�P��6jR��$ l���²`A@�B!�$�-;�H� ��H�j|؃�7ݑf�����A�Fs�ܙm�p��{t �N��o� @k!I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I��_?���_���b#��Ͼ�j��������=�������ы/��(I�$i��1�w��c��F��8��������>��~��$I���m�jJ�;�R���rJ�ߔ/�ec�xM��y�XO��Sb�����2ǟ�z����cN>SR-��^��zjU1�-�O I�$i�ڎA���o&v'u�Y��?�]H1��g畹��b���j���r8�ɨ�&'CI�$I��vJ1��ޟ+| c��Φ�:����w`��O��\a$I�$�O�1(�e:'-���w�dOS��3@�yR��I�$I��vJ�+'\�{����Յ#�;���cK�$IҚdP�&��E�P��=Gc�H�$Iڠ�cP�;(���1����5&.|76����:J�$I���R]qn�1oyG���R�ڠ4Ơ$I�$�a����g�����^݊߼�|U���˃�Az�>�3�M=5����$I�t���Y�_��G?�ӭ�YiU���↳�W�k�[�Ƹ�y~�A�.���I�$I�u��R�"u��|йKlV;�fJ����-�$I�� �J���w1��t�����g/��yϣ)����R�}�U]��3@MJu�],R���r��$I�����Ai��J��q&�S�T�q)wŃ�>C;�L_�a���'%I�$�V�����������Is���qgr�Y)^ЎH�K(ē�{hqq|�����x�*V�V��$I��v�%I�$I̠$I�$I�J�$I��ɠ$I�$I�J�$I��ɠ�=~����'{�����"�7Օ$I�4�Ai#�;:�=���^��*��e��X�Q�$Iڞ�Ԡ��1����ٍ}�������w��j��M���S,x#(I�$mU+�~�ã������t�4}��ۭ��hq�ƶypI�$I���A��?��'���RnxP���USF��}�+i͇;I�$iC�S�R��)#���wN��g=�_�B stream CDR receives . )$}���B;Fc���I�FB����װ �_�0t)'�0���efᤂ�0�w��pt4�M�O@��d endstream Effective November 1, 2017, behavioral health functions transitioned from Cenpatico (a subsidiary of Envolve PeopleCare) to Superior HealthPlan. 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