General Information

Revalidation/Enrollment Update – Important HCPF Information

IMPORTANT UPDATE:

A March Addendum to the coding manual was uploaded 3/1/2017 to the HCPF Department’s website. Please click here for more information.

NOTICE TO PROVIDERS: The Medicaid Revalidation is effective March 1, 2017. If you have not completed the revalidation or enrollment process with Medicaid, you will no longer be able to see BHI Medicaid clients.  It is a requirement of the Center for Medicare/Medicaid Services (CMS) that all providers must be revalidated or enrolled with the state Medicaid plan to continue to received reimbursement for services provided to any Medicaid recipient. Please visit the Department of Health Care Policy & Financing for more information.

Please continue to submit all mental health claims to the appropriate Behavioral Health Organization for the county your client resides in. Do not submit your claims to the State.

If you have any questions, concerns, or inquiring application status, please contact HPE Enrollment/Revalidation Call Center at 1-844-235-2387 or email to COProviderEnrollment@HPE.com  or follow the link to their website.

Manuals
Here you will find the updated manuals BHI utilizes to facilitate a better understanding of the requirements for network providers. The Uniform Service Coding Standards Manual (USCS) is a living document that is updated each fiscal year to maintain consistency between the BHO contract, the OBH contract, the State Plan Amendments, the (b)(3) waiver, and coding guidelines. This document sets forth the requirements of billing procedure codes for behavioral health services covered by the Department and the Office of Behavioral Health.

Provider Bulletins
Behavioral Healthcare, Inc. (BHI) issues provider bulletins as needed to communicate procedures, reminders, and other useful information to our providers and billing professionals. The Provider Bulletin is published quarterly.

Colorado Client Assessment Record (CCAR)
The Colorado Client Assessment Record (CCAR) is a state-required form that must be completed for all members receiving mental health treatment. CCAR forms are not required if the only service being provided is for treatment of a covered substance use diagnosis. The CCAR form is used to capture demographic, administrative, clinical, and outcome data. It is a clinical instrument designed to assess the behavioral health status of a consumer in treatment. Information surrounding the CCAR’s can be found here.

Claims/Eligibility
Helpful information surrounding the process of checking eligibility of members or claims submissions can be found here.

Electronic Referral Process
If you feel your patient requires services at a Community Mental Health Center, you can now refer them easily through BHI’s e-referral system. Please see the description of services for the Community Mental Health Centers in our area to find the one that best suits your patient’s needs. Once you decide on the Community Mental Health Center, click on that center and you will be taken to a referral form that will be sent securely to a designated employee who can assist you and your patient with mental health services. You and your patient being referred will be contacted within 24 hours. Please call (303) 361-8117 with any questions.

Screening
In order to best serve our members with provision of appropriate behavioral health and substance use services, and to continue to exceed quality standards, Behavioral Healthcare, Inc. (BHI) is dedicated to advancing wellness and taking action to reduce negative effects of mental illness and substance use disorders through promotion of early screening and assessment. Towards this effort and dedication, BHI has implemented two screening programs, one for coexisting mental health and substance use disorders using the Simple Screening Instrument for Substance Abuse for our members struggling with anxiety and anxiety disorders, and a second screening program, for trauma in children using the Child PTSD Symptom Scale. These two screening measures are based on scientific evidence, best practice, and industry standards. The screening measures are recommended by BHI for use by providers and practitioners in BHI’s Provider Network based on certain criteria and at regular intervals. The full program description for these screening programs with details on recommended criteria and screening intervals can be found here.

Covered Diagnoses
Need more information regarding ICD-10? The link above includes covered diagnosis crosswalks from ICD-9 to ICD-10, as well as a document covering some frequently asked questions.

Integrated Care
At BHI we promote Integrated Health Care. Integrated Care is a whole-person approach to health care that includes communication and collaboration between all of a patient’s health professionals. It is a team approach to addressing a patient’s health needs, including behavioral health. Whether that means getting behavioral health care at a primary care practice or receiving primary care at a behavioral health facility, the patient’s needs are the primary focus.

Member Resources
Members will find information and links to local and national resources to support you on your path to recovery. We have listed resources that we believe will be helpful, but be aware that we are not responsible for the content of these external websites.