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MagellanOfAz.com

For Providers

Provider Manual : Forms and Attachments

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3.1 Accessing and Interpreting Eligibility and Enrollment Information and Screening and Applying for AHCCCS Health Insurance
Attachment 3.1.1 Key Code Index
Attachment 3.1.2 AHCCCS Rate Codes Descriptions
Attachment 3.1.3 AHCCCS Rate Codes
Form ADHS AE-01 AHCCCS Title XIX-XXI Eligibility Screening
Form ADHS AE-08 Decline to Participate in the Screening
Forma ADHS AE-08 Negación a Participar en la Evaluación y/o en el Proceso de Remisión al Seguro de Salud de AHCCCS (Español)
Form 3.1.1 Tracking of Medicare Part D Enrollment
Form 3.1.2 Tracking of Limited Income Subsidy Status

3.3 Referral Process
Form 3.3.1 ADHS/DBHS Referral to Behavioral Health Services

3.4 Co-payments
Form 3.4.1 Non-XIX or XXI Co-Payment Assessment
Forma 3.4.1 Evaluación de Pago Colateral Sin Título XIX/XXI (Español)

3.8 Outreach, Engagement, Re-Engagement and Closure

3.9 Intake, Assessment and Service Planning
Form 3.9.1 Behavioral Health Assessment and Service Plan
Forma 3.9.1 Evaluación de Salud Mental y Plan de Servicios (Español)
Instruction Guide 3.9.1 Instruction Guide for Behavioral Health Assessment and Service Plan
Form 3.9.2 Birth to 5 Behavioral Health Assessment & Service Plan
Instruction Guide 3.9.2 Instruction Guide for Birth to 5 Behavioral Health Assessment & Service Plan
Forma PM 3.9.2 Hoja de Cobertura del Cliente de Salud de Comportamiento ADHS-DBHS (Español)

3.10 SMI Eligibility Determination
Attachment 3.10.1 SMI Qualifying Diagnosis
Attachment 3.10.2 Substance Abuse Psychiatric Symptomatology
Form 3.10.1 SMI Determination Module

3.11 General and Informed Consent to Treatment
Form ADHS MH-103 Application for Voluntary Evaluation
Forma ADHS MH-103 Solicitud de Una Evaluación Voluntaria (Español)
Form 3.11.1 Substance Abuse Prevention Program and Evaluation Consent
Forma 3.11.1 Permiso de Participación en la Evaluación del Programa de Prevención del uso de Drogas y Alcohol (Español)
Form 3.11.2 Consent for Electroconvulsive Therapy (ECT)
Form 3.11.3 Consent for Treatment - Sample
Form 3.11.4 Consent for ALOC
Forma 3.11.4 Consentimiento para la Evaluatión del Nivel de Cuidado

3.12 Advance Directives
  Advance Directives Resources
Form 3.12.1 Advance Directives Form

3.13 Covered Behavioral Health Services
Attachment 3.13.1 Covered Service Matrix

3.14 Securing Services and Prior Authorization
Attachment 3.14.1 Admission Psych Acute Hospital and Sub-Acute Authorization Criteria
Attachment 3.14.2 Continued Stay Psych Acute Hospital and Sub-Acute Authorization Criteria
Attachment 3.14.3 Admission Residential Treatment Center Authorization Criteria
Attachment 3.14.4 Continued Stay Residential Treatment Center Authorization Criteria
Form 3.14.1 Certification of Need for Level I Facilities (CON)
Form 3.14.2 Re-Certification of Need (RON)
Form 3.14.3 T/RBHA Prior Authorization Request
  Outpatient Electroconvulsive Therapy Criteria for Authorization
  Request For Electroconvulsive Therapy (ECT)
  Psychological Testing Criteria for Authorization
  Request for Psychological Testing Preauthorization
  Pharmacy Prior Authorization Request Form

3.15 Psychotropic Medications: Prescribing and Monitoring
Form 3.15.1 Informed Consent for Psychotropic Medication
Forma 3.15.1 Consentimiento Informado para Tratamiento con Medicamentos Psicotrópicos (Español)

3.17 Transition of Persons
Form 3.17.1 Interagency PNO Client Transfer Form (For Title 19/Title 21 and HB Children Only)
Form 3.17.2 Transfer Protocol Between Provider Network Organizations (PNOs)
Form 3.17.3 Clinical Liaison Update Form

3.18 Pre-Petition Screening, Court Ordered Evaluation and Treatment
Form 3.18.1 Police Mental Health Detention Information Sheet for Court-Ordered Detention
Form 3.18.2 Pre-petition Screening Report
Form ADHS MH-100 Application for Involuntary Evaluation
Form ADHS MH-103 Application for Voluntary Evaluation
Forma ADHS MH-103 Solicitud de Una Evalución Voluntaria (Español)
Form ADHS MH-104 Application For Emergency Admission For Evaluation
Form ADHS MH-105 Petition For Court-Ordered Evaluation
Form ADHS MH-110 Petition For Court-Ordered Treatment - Gravely Disabled Person
Form ADHS MH-112 Affidavit

3.19 Special Populations
Attachment 3.19.1 Notice to Individuals Receiving Substance Abuse Services
Documento Adjunto 3.19.1 Notificacion a Individuos Quienes Reciben Servicios para el Abuso de Estupefacients (Español)
Form 3.19.1 Quarterly PATH Report

3.20 Credentialing and Privileging
Attachment 3.20.1 Examples of College Classes Relevant to Behavioral Health
Form 3.20.1 Supervisor of Clinical Liaisons Attestation of Competencies
Form 3.20.2 BHT Case Supervision Report
Form 3.20.3 Staff Add/Change/Delete

3.21 Service Prioritization for Non-Title XIX/XXI Funding
Attachment 3.21.1 Health Plan & RBHA Medical Institution Notification for Dual Eligible Members
Attachment 3.21.2 Benefits and Cost For People With Medicare (Part D)
Form 3.21.1 AHCCCS Notification to Waive Medicare Part D Co-Payments for Members in a Medical Institution Funded by Medicaid

3.22 Out-of-State Placements for Children and Young Adults
Form 3.22.1 Out-of-State Placement Initial Notice
Form 3.22.2 Out-of-State Placement, 90-Day Update

4.2 Behavioral Health Medical Record Standards
Form 4.2.1 Clinical Record Documentation Form

4.3 Coordination of Care with AHCCCS Health Plans and PCPs
Attachment 4.3.1 AHCCCS Contracted Health Plans Contact Information
Form 4.3.1 Communication Document
Form 4.3.2 Request for Information from PCP

4.4 Coordination of Care with Other Government Entities
Attachment 4.4.1 ACYF Child Welfare Timeframes

5.1 Member Notice Requirements
Form 5.1.1 Notice of Action
Forma 5.1.1 Aviso De Acción (Español)
Form 5.1.2 Notice of Extension of Timeframe for SErvice Authorization Decision Regarding Title XIX/XXI Behavioral Health Services
Forma 5.1.2 Aviso de Extensión de Plazo Para Autorizacion de Decisión Para Servicios de Salud Mental Titulo XIX/XXI(Español)

5.3 Grievance and Request for Investigation for Persons Determined to Have a Serious Mental Illness (SMI)
Form 5.3.1 ADHS/DBHS Appeal or SMI Grievance
Forma 5.3.1 Forma De Apelación ADHS/DBHS o Queja SMI (Español)

5.4 Special Assistance for SMI Members
Form 5.4.1 Notification of Person in Need of Special Assistance
Forma 5.4.1 Notificación de persona con necesidad de atención especial (Español)

5.5 Notice and Appeal Requirements (SMI and Non-SMI/Non-Title XIX/XXI)
Attachment 5.5.1 Notice of SMI Grievance and Appeal Procedure
Documento Adjunto 5.5.1 Aviso de Queja y Apelación Formal de SMI de ADHS/DBHS(Español)
Form 5.5.1 Notice of Decision and Right to Appeal (SMI)
Forma 5.5.1 Aviso de Decisión y Derecho de Apelación (Español)
Form ADHS MH-209 Notice of Discrimination Prohibited (English and Español)
Form ADHS MH-211 Notice of Legal Rights for SMI
Forma ADHS MH-211 Aviso de los Derechos Legales para Personas con una Enfermedad Mental Grave (Español)

5.6 Provider Claims Disputes
Attachment 5.6.1 Provider Claims Disputes Contact List
Attachment 5.6.2 Process for Provider Claims Disputes

6.1 Submitting Claims and Encounters
Attachment 6.1.1 Pseudo ID Numbers

7.1 Fraud and Program Abuse Reporting
Form 7.1.1 Suspected Fraud or Abuse Report
Forma 7.1.1 Sospecha de Fraude o Reporte de Abuso de Programas

7.2 Medical Institution Reporting for Medicare Part D
Form 7.2.1 AHCCCS Notification to Waive Medicare Part D Co-payments for Members in a Medical Institution that is Funded by Medicaid

7.3 Seclusion and Restraint Reporting for Level I Facilities
Form 7.3.1 Seclusion and Restraint Reporting for Level I Facilities

7.4 Reporting of Incidents, Accidents and Deaths
Form 7.4.1 Reporting Incident-Accident-Deaths

7.5 Enrollment, Disenrollment and other Data Submission
Attachment 7.5.1 Timeframes for Data Submission
Form 7.5.1 Demographic Form
Attachment 7.5.2 Timeframes for Data Submission
Attachment 7.5.2 834 Transaction Data Requirements
Form 7.5.2 Initial Intake Form
Attachment 7.5.3 SMI and SED Qualifying Diagnoses Table
Attachment 7.5.4 (Preamble) Behavioral Health Services Diagnosis Code Table
Attachment 7.5.4 (Table) Substance Abuse Disorders Qualifying Diagnoses Table

8.5 Medical Care Evaluation (MCE) Studies
Attachment 8.5.1 Instructions for Completion of Medical Care Evaluation
Form 8.5.1 Medical Care Evaluation (MCE) Study Request for Registration
Form 8.5.2 Summary of Medical Care Evaluation (MCE) Study Methodology
Form 8.5.3 Medical Care Evaluation (MCE) Quarterly Progress Report
Form 8.5.4 Annual Medical Care Evaluation (MCE) Study Report for Level I Providers

9.1 Training and Development
Attachment 9.1.1 Supervision Process User Guide
Form 9.1.1 CFT Supervision Tool

If you have any questions about your services, please call Magellan at 800-564-5465 (TTY: 800-424-9831). For emergencies, call the Crisis Line at 800-631-1314 (TTY: 800-327-9254).



This page last updated: Dec 17, 2008

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