Western Highlands Network
Friday E-Mail Newsletter
Number 71
10/06/2006
The Friday E-Mail is a weekly update for providers by the Services Management Department of Western Highlands Network. Please distribute to all your staff.
SEASONS CHANGE...
AND SO DO THE REQUIREMENTS OF THE NC DIVISION OF MH/DD/SAS!
On October 1, 2006 Western Highlands Network implemented the new state required Screening, Triage and Referral (STR) and PCP Admission forms required by the state for the Access and registration system.
Below is a list of the forms needed in this process.
- The STR form "Standardized Consumer STR Interview and Registration Form" will replace the WH Access Screening form and the WH Demographics form. If you would like to seek an initial authorization for services you may use the STR Form in conjunction with the "Description of Consumer Clinical Issues" form which you will find as an attachment to this bulletin.
- The "Description of Consumer Clinical Issues" form will also act as the Access SAR. If the consumer is transferring from another provider please complete the WHN Transfer Form attached to this e-mail.
The following is an explanation of the processes for consumer scenarios:
1. Medicaid Consumers - Registration Only - Entering the System Through WH Telephone Access
- STR Form - "Registration Only Sections"
- WHN Transfer Form ( if needed)
2. Medicaid Consumer - Registration ("No Wrong Door") - Entering the System Through the Provider
Please fax the following forms to WH Medical Records at (828) 225-2779 within 5 working days of initial contact with the consumer.
Remember, failure to register a Medicaid consumer may jeopardize reimbursement.
(This will not open the case with the LME)
- STR Form complete in full
- WHN Transfer Form ( if needed)
3. Medicaid Consumers ("No Wrong Door") Screening, Registration and Request for Authorization of Services
To register a Medicaid consumer and seek authorization for services
billed through the LME, the following forms should be faxed to Access
at (828) 225-2782 within 5 working days.
- STR Form completed in full
- "Description of Consumer Clinical Issues" form (complete in full - A and C)
- PCP Admission Form
- WHN Transfer Form ( if needed)
4. State Funded Consumers - Screening and Case Opening prior to completion of the DA and PCP Plan
To open the consumer's case in the WH system and request authorizations
for State funded services please fax the following completed 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 and C)
- IPRS Worksheet (only required for case opening)
- PCP Admission Form
- WHN Transfer Form ( if needed)
5. State Funded Consumers - Screening for Consumers who do not meet a Target Pop.
To request authorization for state funded services when NOT opening
the case, fax the following completed 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 and C)
- PCP Admission Form
Please be advised that WHN will pend incomplete forms and administratively deny if not corrected within 14 days.
Word versions of the STR and PCP forms may be obtained via the DMH/DD/SA website in Announcements under Enhanced Services Implementation Updates #11 and #14. Please go to:
www.dhhs.state.nc.us/mhddsas/servicedefinitions/servdefupdates/index.htm
Charlie Schoenheit
Director of Services Management
Western Highlands Network
356 Biltmore Avenue
Asheville, NC 28801
Telephone: (828)258-3511 x2219
FAX: (828) 225-2779
E-Mail: Charlie@westernhighlands.org
Website: westernhighlands.org
