This Bulletin sets forth the steps for obtaining initial authorization and re-authorization of ACT services, as well as discharge, transition and transfer to another agency.
ACT WORK FLOW:
I. Initial Request:
Request for Initial ACT Authorization Request *All New requests for ACT Services:
Complete Initial ACT request in Provider Connect.
For Existing Consumers, please fax hard copies of:
a) Diagnostic Assessment
b) LOCUS
c) IRP
d) ISSP
to the attention of ACT Coordinator (202) 671-2972.
Please note the initial ACT request should not be completed for those consumers that have had previous ACT services:
All initial requests for ACT Services are to be reviewed by the DMH ACT Coordinator.
II. Reauthorization/Continued Stay Request:
Request for Reauthorization/Continued Stay ACT Services:
Complete Ongoing ACT request in Provider Connect
For existing authorizations, the next request will require submission of the ACT Service line only(Basically clinical reviews will occur every 6(six) months)
*For those consumers with a reauthorization start date of October 1, 2006, the Continued Stay ACT Event should be completed.
III. Transition/Discharge Request:
Follow protocol in that the ACT Team and CSA collaborate on the request
All requests should be entered electronically
All transition/discharge requests are to be reviewed by the DMH ACT Coordinator for disposition and tracking
IV. Transfers Across Agencies for ACT Services:
All transfer requests must be directed to the attention of the ACT Coordinator prior to making an electronic submission.
V. Choice of Providers:
Please note that DMH will try to honor all rendering Provider selections. However, Rendering Provider choices are subject to availability/specific eligibility criteria of specialized ACT Teams.
VI. Appeal
Clinical requests pertaining to ACT should be forwarded to the ACT Coordinator.
Any questions should be directed to Kerima A. Gibbons at (202) 673-7126 or [email protected].
