Requesting Authorization for Substance Abuse Services

Level of Care Calculated

• This field displays the LOC calculated by CMBHS based on the information entered into the Assessment by the clinician. This field will display the LOC based on the answers entered into the Assessment.
• If the Assessment has not been completed at the time that the authorization is requested, the Level of Care Calculated will default to blank.
• One of these service packages will display:
  • Intensive Residential Services
  • Supportive Residential Services

 

Level Of Care Recommended (Required for substance abuse services)

• If the client has not been admitted to the business entity, the Level of Care Requested will default to 'None Selected' because there are no services types associated with pre-admission (the default) that require authorization.
• Pre-admission will not be a selectable service package in Level of Care Requested or Level of Care Approved.

Answer Choices:

• Intensive Residential Services
• Supportive Residential

 

Services Service Package Length (Required for substance abuse services)

• This field reflects the length of time the service authorization will last...

 

Reason For Deviation (Required for substance abuse services)

• If the LOC-R is different from the LOC-C, then a reason for the deviation must be documented.
• One of the answer choices must be selected.

  Answer Choices:

  • Client Need
  • Client Choice
  • Continuity of Care per UM Guidelines
  • Resource Limitations

 

• (Required for substance abuse services)If there is a reason other than the answer choices above for the deviation between the calculated and clinician recommended service package, it is documented here.

 

Begin Date (Required for substance abuse services)

• Enter the begin date for the services for which you are requesting authorization.
• You must enter eight numbers that represent the date and CMBHS will put them into the correct format date format mm/dd/yyyy.

 

End Date (Required for substance abuse services)

• The end date cannot be edited to be past the maximum time allowed for that service package. A service will be “unauthorized” if the date the service was delivered is past the new authorization end date.
• You must enter eight numbers that represent the date and CMBHS will put them into the correct format date format mm/dd/yyyy.

 

Authorization Narrative

• This field is optional for substance abuse services except when approved units change the first time.
  • The approved units are different from the defaulted requested units any health services are "Pended" or "Denied" the LOC-R is different than the LOC-C
  • The authorization requester may document any relevant information related to the justification for the request, the client’s special needs or the provider’s circumstances in this text box.
  • The maximum length of data characters you may enter is unlimited.