Billing Manual for Community Care Network Providers

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such as seafood processing, forestry, hospitality, landscaping, construction and agriculture.These industries are all critical to overall economic health across the American South. Manyof these businesses have been hit hard by the economic downturn, and governments at the stateand federal levels must do all that they can to support these businesses so that they are notforced to further reduce their workforce. Therefore it is essential that wages for H-2B workersremain in line with the economic realities faced by these businesses, which often operate onextremely thin profit margins. Southern Governors are concerned that changes to themethodology for calculating wages, as proposed by the Department of Labor (DOL), wouldincrease wages to the extent that they are no longer reflective of economic realities, and wouldresult in a significant loss of jobs in these industries as companies are forced into bankruptcy.As DOL contemplates changes to the wage methodology, it should consider the economicpressures faced by these industries, and provide ample time for businesses to prepare for anychanges to the wage methodology.• Locate a satellite U.S. Patent and Trademark Office in the American South—Therecently passed America Invents Act includes authorization for four new U.S. Patent andTrademark satellite offices across the nation. Southern Governors strongly urge placement ofat least one of those offices in the American South. With over 40 percent of the U.S.population and nearly a quarter of the nation's landmass, the American South is a region whereinnovation happens. Southern Governors are strongly committed to creating an environmentthat supports private sector innovation, and our states already stand out on a wide range offactors that are fundamental to a strong innovation ecosystem, including global engagement, arobust research environment, and scientific and technically knowledgeable residents. Withtalented and dynamic people and organizations, a strong commitment to science, technology,education, research, and business development, and a long history of public-privatecooperation, the American South represents an excellent choice in which a USPTO satelliteoffice should be located.
Clinical Fax by County:Adams 1-866-418-0366 Allegheny 1-888-251-0087 Berks 1-866-418-0366Blair 1-855-473-2359 Bradford 1-866-294-3935 Cameron 1-866-294-3935Carbon 1-866-901-8367 Centre 1-866-294-3935 Chester 1-888-589-6559Clarion 1-866-294-3935 Clearfield 1-866-294-3935 Clinton 1-855-473-2360Columbia 1-866-294-3935 Elk 1-866-294-3935 Erie 1-855-892-8495Forest 1-866-294-3935 Huntingdon 1-866-294-3935 Jefferson 1-866-294-3935Juniata 1-866-294-3935 Lackawanna 1-866-284-9184 Luzerne 1-866-284-9184Lycoming 1-855-473-2360 McKean 1-866-294-3935 Mifflin 1-866-294-3935Monroe 1-866-901-8367 Montour 1-866-294-3935 Northumberland 1-866-294-3935Pike 1-866-901-8367 Potter 1-866-294-3935 Schuylkill 1-866-294-3935Snyder 1-866-294-3935 Sullivan 1-866-294-3935 Susquehanna 1-866-284-9184Tioga 1-866-294-3935 Union 1-866-294-3935 Warren 1-866-294-3935Wayne 1-866-294-3935 Wyoming 1-866-284-9184 York 1-866-418-0366TTY for people who are Deaf/Hard-of-Hearing 1-877-877-3580Spanish Line 1-866-229-3187Autism Support Line 1-866-415-1708PA Child Abuse Hotline 1-800-932-0313Community Care Provider Manual | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 7
Page 5: APPENDIX A.2. Confidentiality 130AP
Page 9 and 10: Outpatient Therapy 1MD OutpatientMe
Page 11 and 12: Functional Familytherapy (FFT)Multi
Page 13 and 14: Non-Acute PartialHospitalizationNot
Page 15 and 16: I.A. Code of EthicsCommunity Care
Page 17 and 18: esources and evaluated on their pro
Page 19 and 20: Confidentiality policies including
Page 21 and 22: Within 30 minutes for urban areas.W
Page 23 and 24: I.E. Care Management Team“Advocat
Page 25 and 26: In order to serve special populatio
Page 27 and 28: Psychiatric Rehabilitation Clubhous
Page 29 and 30: always be considered in light of th
Page 31 and 32: Tell their provider everything they
Page 33 and 34: and calls received on the programs
Page 35 and 36: II.D.1e EvaluationIndividuals parti
Page 37 and 38: II.D.2b GoalsThe goals of Community
Page 39 and 40: II.D.3 Providers’ Role in the Pre
Page 41 and 42: Community Care has a total of 30 ca
Page 43 and 44: Department of Health and provide in
Page 45 and 46: An explanation of the grievance pro
Page 47 and 48: Upon request, the member will be as
Page 54 and 55: Notices must be in alternate format
Page 56 and 57:
Community Care is a party to the he
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The following sections provide info
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members, practitioners are asked to
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Accreditation of Healthcare Organiz
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III.B.4 Facility ReassessmentFacili
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present relevant information, and t
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contracting, performance evaluation
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the implementation and application
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III.C.4 Ability to Give Informed Au
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When such disclosure to health care
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Practitioners are informed of the r
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Medication(s) that have been prescr
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III.E. Clinical Practice Guidelines
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Community Care has developed a plan
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eing served and uses strategies to
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dialogue and intervention may occur
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For any questions about providing s
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If you, as a Community Care provide
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When the precertification is for se
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ORA member expresses a readiness fo
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IV.E.3 Transition of Care to anothe
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Billing ManualCommunity Care Behavi
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Even though an authorization may be
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Timely File requests are to be mail
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Provide an alternative to the use o
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Required Claim FieldsIn the followi
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24C EMG Not required24D Procedure C
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17 Discharge Status Required forINP
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67a-q Diag. Code Required68 Unlabel
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• Explanation of Benefits (EOB) i
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Many of the services covered by Com
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Community Care Behavioral Health Or
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Community Care Procedure Code: The
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C/FST: Consumer/Family Satisfaction
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Medicaid/Medical Assistance identif
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APPENDICESAPPENDIX A.1. Fraud, Wast
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. The provider will also receive a
Page 130 and 131:
APPENDIX A.2. ConfidentialityPOLICY
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A Facility or group practice name,
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Confidential data and information s
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The medical director or his/her des
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The privacy officer will review the
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collection and use of member identi
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Protection of information disclosed
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If a member is granted access to re
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Under some circumstances, it may be
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164.504(e)(ii)(A)).They will take a
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must verify that the member has sig
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esults, billing records, and treatm
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equestor destroy the information, o
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The member has the right to request
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Policy on Release of Information Re
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y the written authorization of the
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If minor consents to treatment or c
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Current patients or clients or the
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If the client has given written aut
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Confidentiality policies pursuant t
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“Statement of Confidentiality”
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Findings will be reported to senior
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information and by signing this sta
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Community Care has identified circu
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NameAddress (es)Zip CodeDiagnosis (
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Community Care has the right to den
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Member identifiable information may
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Community Care extends all reasonab
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For research purposes.On behavioral
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See the policy on Transition of Pri
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Community Care does not collect inf
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The request must be in writing. Cre
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All statements to the media includi
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• The name, or title, and the tel
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APPENDIX A.4. Significant Member In
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Orientation and ongoing provider ed
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CONSENT FOR RELEASE OF INFORMATIONM
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Authorization for the Release of Dr
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___________________________________
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APPENDIX C.1. Priority PopulationsM
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Second priority is associated with
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3. Secondary Data - OMHSAS will dev
Page 214 and 215:
BEHAVIORAL HEALTH MANAGED CARE ORGA
Page 216 and 217:
APPENDIX E.1. Companion Guide for N
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