Release Notes (7.63)
- 05.10.2019
|
Texas Health and
Human Service Commission (HHSC) Clinical Management
for Behavioral Health Services (CMBHS) Release Information Date May 10, 2019 |
||
|
Page or Function |
Description of
Change and/or User
Instructions |
Business
Entity/User Type Impacted |
|
Substance Use Disorder Treatment
Plans, Treatment Plan Reviews, and Claims |
The Change For Substance Use Disorder (SUD) providers of Outpatient and Residential
Treatment services only, CMBHS has deployed a new function that ensures that prior
to submission to HHSC for payment, claims meet the Texas Administrative Code
(TAC), Section 448 requirements for Treatment Planning. CMBHS will now check to see that a Treatment Plan/Review is
documented in CMBHS within 5 client service
days of the Begin Service for an included
service. (See Definitions Below) The addition of this function to CMBHS does not reflect a new documentation
requirement; it is a new method of enforcing a longstanding requirement of
the TAC, Section 448. Definitions Service
Days – days a client receives services. For residential services, this is
everyday the client is present in the residence and for outpatient services,
this is every day the client receives an outpatient service. Included
Services - the services
included in this change are Intensive Residential, Supportive Residential and
Outpatient substance use treatment services for adults, youth and specialized
female and only when
DSHS Program Funding or BMO is the funding source. Medicaid and
other funding sources are not impacted. BMO – a
Behavior Management Organization is the term that has recently replaced LBHA
in CMBHS. This name change allows functions that were previously only used by
LBHAs to be used by more organization types. The name change has no impact on
a BHO’s authority or functions Rules 1. An SUD Treatment Plan/Review created in
collaboration with and signed by the client, must be entered in CMBHS in
Closed Complete status by the end of the fifth (5th) service day after the Service Begin date. 2. CMBHS will
not permit submission of claims for a client whose Treatment Plan/Review is not
Closed Complete after the fifth
(5th) day of service has passed. 3.
Before the fifth (5th) service
day, providers may submit claims even if the Treatment Plan/Review is not in Closed Complete. 4.
After the fifth (5th) service
day, providers may not submit claims unless the Treatment Plan/Review for the
client is in Closed Complete. Services provided on the days where the Treatment Plan/Review is
delinquent can never be billed. 5.
After the Treatment Plan/Review is in Closed Complete, CMBHS will again permit
submission of claims for services provided on that day, and thereafter but
not for the services provided on days when the Treatment Plan/Review was delinquent. 6.
Whenever a Service
Begin for a new included service is added for the client, the Treatment Plan/Review must be updated and placed in Closed Complete, within five days of
the new Service Begin. 7. CMBHS has
warning messages in place to let users know when these deadlines are
approaching and have passed. Example: If a Treatment
Plan/Review is not in Closed Complete on service day 6, CMBHS will only allow
submission of claims for service days 1 through 5. If a Treatment Plan is
completed on service day 7, CMBHS will allow submission of claims for service
day 7 but not for service day 6. |
SUD Treatment Services Providers, Local Mental Health Authorities/Local
Behavioral Health Authorities that provide SUD Treatment Services |
|
CMBHS has created a new add-on role called
“Exclusion” that can be assigned only to a Security Administrator or a
Clinical Supervisor. The objective is give the user ability to exclude a
Progress Note record from the count of service days. This function can only
be used when the note has been entered into a client record in error. (Details
will be included in the HHSC CMBHS Training that will be provided for this
function) |
SUD Treatment Services Providers, Local
Mental Health Authorities/Local Behavioral Health Authorities that provide
SUD Treatment Services Treatment
Services |
|
|
CMBHS has
a new page, the Business Rule Suspension page, available only to HHSC System Administrators
that allows this change to be disabled for one or more days for a provider or
group of providers when extraordinary circumstances make it impossible to
comply with the requirement. Examples of extraordinary circumstances include
natural and man-made disasters, power shortages, or epidemics, and CMBHS
system unavailable for maintenance. (Details will be included in the HHSC
CMBHS Training that will be provided for this function) |
||
|
Substance Use Disorder Service Begin |
A
Service Begin record can now be deleted if it is created in a client record
in error AND no records have been
created for the new Service Type. The
new delete function only works if a Service Begin is created and the user
determines they have made an error before they create any documents for the
new service such as a Progress Note, Day Rate Attendance, Treatment
Plan/Review or a Service End Assessment.
If
you have created a new Service Begin and documents for the service, you must
complete a Service End and a Service End Assessment and then create a new
Service Begin. |
SUD Treatment Services Providers, Local
Mental Health Authorities/Local Behavioral Health Authorities that provide
SUD Treatment Services |
|
Substance Use Disorder Progress
Notes |
A
Progress Note with a funding source of DSHS Program Funding or BMO is only billable with the Contact
Type of Telephone if it is for the Service Type Outpatient – Youth, Outpatient
(Specialized Female) – Youth, Outpatient - Youth CYT Wraparound or Outpatient
(Specialized Female) - Youth (CYT Wrap-around) and it is for one of these
services: Adolescent Support, Family Support - Single Family or Family Support
w/o Client - Single Family. If
you are submitting a Progress Note for a service other than one of the
Outpatient Services for Youth listed above and/or with a different funding
source, CMBHS will not prevent you from creating it with the Contact Type of
Telephone. When submitted as a claim, it will be paid or denied depending on
whether the funding source permits the Contact Type of Telephone for that
service. |
SUD Treatment Services Providers, Local
Mental Health Authorities/Local Behavioral Health Authorities that provide
SUD Treatment Services |
|
If you have problems
using CMBHS please contact the |
||