Authorization Timeline Changes

AUTHORIZATION TIMELINE CHANGES/

REQUIRED DOCUMENTATION

FOR DIRECT ADMIT SERVICES*

(Last updated 4-8-2009)

SERVICE / INITIAL AUTH / REQUIRED DOCUMENTS INITIAL / AUTH TIME GUIDELINES: INITIAL / REQUIRED DOCUMENTS: CONCURRENT / AUTH TIME GUIDELINES:
CONCURRENT/ONGOING / REQUIRED DOCUMENTS: ONGOING
INTENSIVE IN HOME / No pass through
PA required first day / ITR
Intro PCP / Up to 30 days auth / Completed PCP
New ITR
Any Ax info you want to submit / Up to 60 days / PCP Update
New ITR
MST / No pass through
PA required first day / ITR
Intro PCP / Up to 30 days auth / Completed PCP
New ITR
Any Ax info you want to submit / Up to 120 days / PCP Update
New ITR
CST / No pass through
PA required first day / ITR
Intro PCP / Up to 30 days auth / Completed PCP
New ITR
Any Ax info you want to submit / Up to 90 days / PCP Update
New ITR
ACTT / No pass through
PA required first day / ITR
Intro PCP / Up to 30 days auth / Completed PCP
New ITR
Any Ax info you want to submit / Up to 180 days / PCP Update
New ITR
Community Support
Individual/Group Child & Adult / No pass through
PA required firstday / ITR
Intro PCP / Up to 90 days auth / Completed PCP
New ITR
Any Ax info you want to submit / Up to 90 days / PCP Update
New ITR
SAIOP / No pass through
PA required first day / ITR
Intro PCP / Up to 30 days auth / Completed PCP
New ITR
Any Ax info you want to submit / Up to 60 days auth / PCP Update
New ITR
SACOT / No pass through
PA required first day / ITR
Intro PCP / Up to 60 days auth / Completed PCP
New ITR
Any Ax info you want to submit / Up to 60 days auth / PCP Update
New ITR
TCM Non _ Waiver / 8 hour pass through – once in a lifetime
PA required after first 8 hours / CTCM
Intro PCP
Comprehensive Clinical Assessment
NCSNAP / Up to 90 days auth / Completed PCP for non-CAP consumer
New CTCM
Any Ax info you want to submit / Up to 90 days / PCP 90 day Update
or
Annual PCP
CTCM
Annual NCSNAP
TCM CAP-MR/DD Waiver Recipients / Initial POC
CTCM
NCSNAP / CTCM
POC
NCSNAP / Annual auth to coincide with CNR reviews
(average of 240 units/year) / Resubmit with each CNR request unless more hours are required. Additional TCM units would be submitted on CTCM form with an updated POC. / Annual authorization

*** ALL TIMELINES IN RED ARE CHANGES FROM PREVIOUS AUTHORIZATION TIMELINES. PLEASE PAY SPECIAL ATTENTION TO THESE.

*These are services where a consumer can be directly admitted from STR or as a walk in to your agency. The Intro PCP is for consumers who have never received a MH/SA/DD service in the past OR who have been discharged from all services for at least 60 days.

IMPORTANT REMINDER

GOING FORWARD ALL CONCURRENT REQUESTS WILL REQUIRE AN UPDATED PCPor REVISIONTHAT HAS BEEN REVIEWED NO MORE THAN 30 DAYS PRIOR TO REQUESTED START DATE TO BE SUBMITTED OR YOU REQUEST WILL BE RETURNED.