Common use of Psychiatric Residential Treatment Facility Clause in Contracts

Psychiatric Residential Treatment Facility. If an Enrollee’s MCO enrollment changes during a PRTF stay, the new MCO will be financially responsible for the stay beginning on the first day of coverage with the new MCO. The new MCO will honor the previous MCO’s prior authorization through the end date of the previous MCO’s authorization or through the end of the month that the new MCO becomes effective, whichever date is earlier. Fee-for-service to MCO, and MCO to MCO, authorizations will be honored. If an Enrollee becomes Medicaid eligible and enrolled in the MCO while admitted to the PRTF, the certification of need for services is completed by the treatment team at the PRTF.