Common use of Authorization Requests Clause in Contracts

Authorization Requests. The BHRS Deputy Director of Child and Youth Services or designee will authorize payment for all admissions of San Mateo County clients to the Day Treatment Rehabilitative Services program. Authorization will be based at a minimum on medical and service necessity criteria in State Medi-Cal guidelines and regulations. In order to be reimbursed for services Contractor must meet the following authorization requirements: i. Contractor must request prior authorization for payment from County using the Authorization Form or a similar from approved by County, and clinical documentation that establishes the need for the service. ii. Contractor must provide an additional prior authorization for services that exceed five (5) days per week. iii. Contractor must request authorization for the continuation of services at least every six (6) months or more frequently, if requested by County. iv. Contractor must request prior authorization for the provision of counseling and other similar intervention services beyond those provided in the Rehabilitative Day Treatment Services. These services may not be provided to a Rehabilitative Day Treatment Services client during the Rehabilitative Day Treatment Services program hours, even if such service is authorized. (Excluded from this authorization are services to treat emergency and urgent conditions, and Therapeutic Behavioral Services that are provided on the same day as Day Treatment Rehabilitative