Behavioral Health Providers Sample Clauses

Behavioral Health Providers. As applicable, behavioral health providers shall maintain Medical Records in conformity with TCA 33-3-101 et seq. for persons with serious emotional disturbance or mental illness. Behavioral health providers shall also maintain Medical Records of persons whose confidentiality is protected by 42 CFR Part 2 in conformity with that rule or TCA 33-3-103, whichever is more stringent.
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Behavioral Health Providers. If Provider is a behavioral health service provider, Provider must meet DMAS’ qualifications as outlined in the most current DMAS behavioral health provider manuals, including the community mental health rehabilitative services, mental health clinic, ARTS manual and psychiatric services provider manuals found at: xxxxx://xxx.xxxxxxxxxxxxxxxx.xxxx.xxxxxxxx.xxx/wps/portal/ProviderManual
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Behavioral Health Providers. The ICDS Plan must assure Beneficiary’s access to all Medicaid-covered behavioral health services as specified in Appendix A. Provider Credentialing, Recredentialing, and Board Certification 2.7.10.1. The ICDS Plan must adhere to managed care standards at 42 C.F.R. § 438.214 and 42 C.F.R. §§ 422.204 and 422.205, and must be accredited by NCQA.
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Behavioral Health Providers. The following provisions shall apply if Provider is a behavioral health provider. a) Provider shall provide inpatient psychiatric services to Enrollees and schedule the Enrollee for outpatient follow-up care prior to discharge from the inpatient setting with the outpatient treatment occurring within seven Calendar Days from the date of discharge. b) Provider shall complete the ODMHSAS Customer Data Core form located at xxxxxxx.xxx/xxxxx/XXXXXXxxxx/xxx_XXXXX_Xxxxx.xxx as a condition of payment for services provided under the State Contract; c) Provider shall provide treatment to pregnant Enrollees who are intravenous drug users and all other pregnant substance users within 24 hours of assessment. d) Provider agrees that Company will obtain the appropriate Enrollee releases to share clinical information and Enrollee health records with community-based behavioral health Providers, as requested, consistent with all State and federal confidentiality requirements and in accordance with Company policy and procedures. (State Contract §1.14.1.3.2) e) Provider shall meet the following “Appointment Time” obligations (State Contract §1.14.3.4):
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Behavioral Health Providers. Behavioral Health Providers shall ensure that all Covered Persons receiving inpatient psychiatric services are scheduled for outpatient follow-up and/or continuing treatment prior to discharge from the inpatient psychiatric hospital if the Provider is aware of the Covered Person’s inpatient hospitalization status. Behavioral Health Providers will be provided daily reports identifying Covered Persons known to be admitted to an inpatient facility.
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Behavioral Health Providers. If Participating Provider is a behavioral health provider, Participating Provider will coordinate with Primary Care Providers and specialists conducting EPSDT screenings. (Section V, C.2.j).
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Behavioral Health Providers. The Contractor shall develop a network of appropriately credentialed behavioral health Providers to assure the availability of services for both adults and children and to meet the general Access requirements described in Special Contract Exhibit C.
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Behavioral Health Providers. The following provisions shall apply if Provider is a behavioral health provider. a) Provider shall provide inpatient psychiatric services to Covered Persons and schedule the Covered Person for outpatient follow-up or continuing treatment prior to discharge from the inpatient setting with the outpatient treatment occurring within seven (7) Calendar Days from the date of discharge. b) Provider shall complete the OHCA Customer Data Core (CDC) form located at xxxx://xxx.xxxxxxx.xxx/picis/CDCPAForms/arc_CDCPA_Forms.htm as a condition of payment for services provided under the Model Contract; c) Provider shall provide treatment to pregnant Covered Persons who are intravenous drug users and all other pregnant substance users within 24 hours of assessment. d) Provider agrees that Company will obtain the appropriate Covered Person releases to share clinical information and Covered Person health records with community-based behavioral health Providers, as requested, consistent with all State and federal confidentiality requirements and in accordance with Company policy and procedures. (Model Contract 1.12.2.4.2) e) Provider shall meet the following “Appointment Time” obligations (Model Contract
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Behavioral Health Providers. 3.1.6.1 The Contractor shall have a sufficient number of Behavioral Health Providers to attend to the Behavioral Health needs of the Enrollees. The Contractor shall make available all specialties specified in this Section 9.3.1.6.
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Related to Behavioral Health Providers

  • Behavioral Health Services Behavioral health services include the evaluation, management, and treatment for a mental health or substance use disorder condition. For the purpose of this plan, substance use disorder does not include addiction to or abuse of tobacco and/or caffeine. Mental health or substance use disorders are those that are listed in the most updated volume of either: • the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association; or • the International Classification of Disease Manual (ICD) published by the World Health Organization. This plan provides parity in benefits for behavioral healthcare services. Please see Section 10 for additional information regarding behavioral healthcare parity. This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.

  • Clinical Management for Behavioral Health Services (CMBHS) System 1. request access to CMBHS via the CMBHS Helpline at (000) 000-0000. 2. use the CMBHS time frames specified by System Agency. 3. use System Agency-specified functionality of the CMBHS in its entirety. 4. submit all bills and reports to System Agency through the CMBHS, unless otherwise instructed.

  • HEALTH PROGRAM 3701 Health examinations required by the Employer shall be provided by the Employer and shall be at the expense of the Employer. 3702 Time off without loss of regular pay shall be allowed at a time determined by the Employer for such medical examinations and laboratory tests, provided that these are performed on the Employer’s premises, or at a facility designated by the Employer. 3703 With the approval of the Employer, a nurse may choose to be examined by a physician of her/his own choice, at her/his own expense, as long as the Employer receives a statement as to the fitness of the nurse from the physician. 3704 Time off for medical and dental examinations and/or treatments may be granted and such time off, including necessary travel time, shall be chargeable against accumulated income protection benefits.

  • Physician Visits This plan covers the services of a physician or other provider in charge of your medical care while you are inpatient in a general or specialty hospital.

  • Pharmacy Services The Contractor shall establish a network of pharmacies. The Contractor or its PBM must provide at least two (2) pharmacy providers within thirty (30) miles or thirty (30) minutes from a member’s residence in each county, as well as at least two (2) durable medical equipment providers in each county or contiguous county.

  • Outpatient Services Physicians, Urgent Care Centers and other Outpatient Providers located outside the BlueCard® service area will typically require You to pay in full at the time of service. You must submit a Claim to obtain reimbursement for Covered Services.

  • Mental Health Services This agreement covers medically necessary services for the treatment of mental health disorders in a general or specialty hospital or outpatient facilities that are: • reviewed and approved by us; and • licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a general or specialty hospital or outpatient facility. We review network and non-network programs, hospitals and inpatient facilities, and the specific services provided to decide whether a preauthorization, hospital or inpatient facility, or specific services rendered meets our program requirements, content and criteria. If our program content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below.

  • Extended Health Plan An employee who makes an election under this provision must enrol in each and every of the benefit plans and shall not be entitled to except any of them.

  • Extended Health Care Plan ‌ The Employer shall pay the monthly premium for regular employees entitled to coverage under a mutually acceptable extended health care plan.

  • Medical Verification The Town may require medical verification of an employee’s absence if the Town perceives the employee is abusing sick leave or has used an excessive amount of sick leave. The Town may require medical verification of an employee’s absence to verify that the employee is able to return to work with or without restrictions.

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