august 2015 psychotherapy notes - hsc health · adapted from the clinical documentation sourcebook...
TRANSCRIPT
August 2015 Dear Mental Health Provider, HSCSN is notifying you of documentation requirements for mental health services
two important updates regarding the authorization process and :
1.
It has come to our attention that many providers are providing psychotherapy notes in lieu of behavioral health treatment plans/outpatient treatment reports when requesting ongoing mental health services for enrollees. Effective immediately, HSCSN will no longer accept psychotherapy notes and will require the behavioral health treatment plan or an outpatient treatment report be submitted as documentation for continued treatment. A sample report is attached for your reference. This change will ensure compliance with the District of Columbia Mental Health Information Act of 1978, which limits the disclosure of mental information to 3rd party payers.
2. In order to improve provider and enrollee satisfaction, HSCSN is simplifying the
authorization process for mental health services. Effective immediately, Care Managers will authorize services in the following manner:
Type of Service Requested
Benefit Initial Authorization Requirements
Continued Authorization Requirements
Medication Management
Plan allows 12 visits/year
Initial treatment plan Updated treatment plan or treatment report – required every 3 months
Individual, Group and Family Therapy
Plan allows 90 visits/six months
Initial treatment plan Updated treatment plan or treatment report – required every 3 months
The treatment plan or treatment report must be received by the Care Manager within 30 days of initiating services and every six to 12 months for continued authorization, depending on the authorized service (see table). To reach an HSCSN Care Manager for authorization of medication management or psychotherapy services, please phone or fax:
Telephone: (202) 467-2737 Fax Numbers: (202) 721-7190, -7191, -7192 or -7193
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Health Services for Children with Special Needs, Inc. 1101 Vermont Avenue NW, Ste 1201, Washington, DC 20005 202.467.2737 www.hscsn-net.org The HSC Pediatric Center 1731 Bunker Hill Road NE, Washington, DC 20017 202.832.4400 www.hscpediatriccenter.org
HSC Home Care, LLC 1731 Bunker Hill Road NE, Washington, DC 20017 202.635.5756 www.hsc-homecare.org The HSC Foundation 2013 H Street NW, Ste 300, Washington, DC 20006 202.454.1220 www.hscfoundation.org
Adapted from The Clinical Documentation Sourcebook – The Complete Paperwork Resource for Your Mental Health Practice 4th Ed. 2009.
Outpatient Treatment Report (SAMPLE)
Enrollee name: DOB: Date ID#: No. of sessions since last review: Intake date:
Initial Diagnosis Axis I
Axis II Axis IIIAxis IVAxis V
Current Diagnosis Axis I
Axis II Axis IIIAxis IVAxis V
Purpose of Treatment Review
Change in diagnosis
Estimated length of treatment reached Required periodic review Increased or attempted suicidal concerns
Significant change in treatment plan Change in treatment or therapist
Significant change in functioning level Other:
Describe any changes in the client’s condition noted above:
Progress:
Setbacks/Impairments:
What actions are needed at this time? Describe needed services:
Adapted from The Clinical Documentation Sourcebook – The Complete Paperwork Resource for Your Mental Health Practice 4th Ed. 2009.
Treatment Plan Review Refer to previous Treatment Plan or Treatment Review.
Current Goal 1 Met yet?
Y N Target date if not met yet
Describe current progress toward objectives:
Current Goal 2 Met yet?
Y N Target date if not met yet
Describe current progress toward objectives:
Current Goal 3 Met yet?
Y N Target date if not met yet
Describe current progress toward objectives:
Current Goal 4 Met yet?
Y N Target date if not met yet
Describe current progress toward objectives:
New Goal 1
Target date: Problem area:
Objectives:
Treatment:
Services (and frequency) needed:
New Goal 2
Target date: Problem area:
Objectives:
Treatment:
Services (and frequency) needed:
Therapist: Date: / /
Address:
Phone Number:
Fax Number:
Adapted from The Clinical Documentation Sourcebook – The Complete Paperwork Resource for Your Mental Health Practice 4th Ed. 2009.