ADMISSION AND DISCHARGE. For inpatient services, an admission occurs upon the formal acceptance by the SUDRF of a TRICARE beneficiary for the purpose of occupying a bed with the reasonable expectation that the patient will remain at least 24 hours, and with the registration and assignment of an inpatient number or designation. A discharge occurs at the time that the SUDRF formally releases the patient from inpatient status; or when the patient is admitted to any other inpatient setting, (e.g., an acute mental or medical hospital. For inpatient services, the day of admission is considered a day of care for payment purposes; the day of discharge is not.
ADMISSION AND DISCHARGE. (a) An admission occurs upon the formal acceptance by the PHP of a beneficiary for the purpose of participating in the therapeutic program with the registration and assignment of a patient number or designation.
ADMISSION AND DISCHARGE. (a) An admission occurs upon the formal acceptance by the RTC of a TRICARE beneficiary for the purpose of occupying a bed with the reasonable expectation that the patient will remain at least 24 hours, and with the registration and assignment of an inpatient number or designation.
ADMISSION AND DISCHARGE. (a) An admission occurs upon the formal acceptance by the OTP of a beneficiary for the purpose of participating in the therapeutic program with the registration and assignment of a patient number or designation.
ADMISSION AND DISCHARGE. Garfield Wellness & Recovery Center is a non-medical community care facility that provides services in a homelike environment to 18 to 59 years old adults with persistent or chronic mental illness. As an Adult Residential Treatment Services (ARTS) facility, services must be authorized by MHPs. MHPs must utilize referral and/or concurrent review in addition to authorizing all ARTS. MHPs may not require prior authorization, if the MHP refers a beneficiary to a facility for ARTS the referral may serve as the initial authorization as long as the MHP specifies the paraments (e.g., number of days authorized) of the authorization. The MHP must then reauthorize Medically necessary ARTS services, as appropriate, concurrently with the beneficiary’s stay and based on beneficiary’s continued need for services. In the absence of an MHP referral, MHPs shall conduct concurrent review of treatment authorizations following the first day of admission to the ARTS program through discharge. MHPs may elect to authorize multiple days, based on the beneficiary’s mental health condition, for as long as services are medically necessary. • Admission Criteria – Referrals for admission to this ARTS will come only through Placer County Health and Human Services Adult System of Care Per DHCS Information Notice #19-026, COUNTY will re-authorize treatment services based upon medical necessity ARTS services. The initial authorization by COUNTY is six (6) months in duration. If the resident requires on-going services after six months then COUNTY, as appropriate, will conduct concurrent review based on continued medical necessity and need for services. The adults served at this program are those considered persistently mentally disabled, who would otherwise be placed in a state hospital or acute mental health facility, and for whom this setting is the least restrictive alternative to meet their needs. The following persons may not be admitted to the SRF: o In accordance with Fire Marshal Clearance for the SRF occupancy, persons who are non- ambulatory may not be admitted to the facility. o Individuals that require a level or levels of medical care not provided, who would be appropriately served by an acute psychiatric hospital, or who are diagnosed only with substance use or eating disorder will not be considered appropriate for the SRF placement. o Persons with prohibited health conditions as listed in CCR Title 22, Division 6, Article 8, Section 81091(a) will not be admitted to the SRF. o...
ADMISSION AND DISCHARGE. BMS utilizes a Utilization Management Contractor (UMC) or a Managed Care Organization (MCO) to certify member medical necessity for admission and continue stays in all PRTF’s. BMS is not financially responsible for reimbursement of a West Virginia Medicaid member who is not prior authorized for admission or continue stays in any facility by the UMC or MCO. An admission occurs upon the formal acceptance by an approved enrolled PRTF of a West Virginia Medicaid member who has been prior authorized for admission by the Medicaid URC or MCO. A discharge occurs at the time the PRTF formally releases the West Virginia Medicaid member from the PRTF. A facility must provide sufficient preparation and/or orientation to West Virginia members to ensure a safe and orderly transfer or discharge from the facility. The facility staff are required to start discharge planning that is to include education for residents, families/guardians, and other involved entities on the available services in their community including but not limited to services available through the Children with Serious Emotional Disorder Waiver, Mobile Crisis Response, Intensive Outpatient, and other Outpatient Services. Discharge planning for any members 17.5 – 21 years of age must include consideration, education, and referral to Assertive Community Treatment (ACT) Program. Criteria must be reviewed and discussed with the member and/or family. The day of admission is considered a day of care; the day of discharge is not considered a day of care and is not reimbursable. BMS will only reimburse eight therapeutic leave days in a calendar year to ensure a warm transfer of the member back into a lower level of care. Days incurred beyond the eight days, when a member is not directly involved with the PRTF or PRTF staff will not be reimbursed. While a member is utilizing the therapeutic leave days the PRTF must make therapy services available for the member and/or family either in person or via telehealth. Therapeutic pass would occur when clinically appropriate, toward the end of a member’s placement to ensure adequate transition into the family/xxxxxx family home. A therapeutic pass is defined as a time of absence when a member spends one (1) hour up to 23 hours away from the PRTF without support from direct staff. The maximum allowable and reimbursable therapeutic pass per PRTF shall be limited to four (4) passes per calendar year. The facility may not bill the West Virginia Medicaid member, family, or pa...
ADMISSION AND DISCHARGE. Integrated FSP program.
ADMISSION AND DISCHARGE. 1. The County Youth Case Management Unit will manage the overall referral and authorization process in collaboration with the review/authorization committees.
ADMISSION AND DISCHARGE. (a) For inpatient services, an admission occurs upon the formal acceptance by the SUDRF of a TRICARE beneficiary for the purpose of occupying a bed with the reasonable expectation that the patient will remain at least 24 hours, and with the registration and assignment of an inpatient Participation Agreement For Substance Use Disorder Rehabilitation Facility (SUDRF) Services For TRICARE Beneficiaries number or designation. A discharge occurs at the time that the SUDRF formally releases the patient from inpatient status; or when the patient is admitted to any other inpatient setting, (e.g., an acute mental or medical hospital. For inpatient services, the day of admission is considered a day of care for payment purposes; the day of discharge is not.
