FY15 Provider Manual Table of Contents

Helping Families. Supporting Communities. Empowering Individuals.


FY15 Provider Manual

Table of Contents


I. INTRODUCTION

  1. DHS/DMH Mission/Vision Statement
  2. Philosophy of Recovery
  3. Illinois Mental Health Collaborative: Consumer and Family Handbook 
  4. FY 15 Provider Manual - Definitions
  5. Illinois Mental Health Collaborative for Access and Choice 

II. PROVIDER ELIGIBILITY

  1. DMH Community Services Contract-Attachment B
  2. Application, Certification and Enrollment with HFS (Medicaid)
    1. Becoming a Medicaid Certified Community Mental Health Provider
    2. The Bureau of Accreditation, Licensure and Certification's (BALC)
    3. HFS General Provider Enrollment Requirements
    4. HFS Medical Provider Handbook - Chapter CMH-100
    5. Chapter CMH-200 Children's Mental Health (SASS) (pdf) 
    6. Appendix (pdf)
  3. Community Based Service (Rule 132)
  4. DMH Provider Enrollment
    1. DMH Provider Medicaid Enrollment
    2. Forms for Provider Database
  5. Accreditation Standards/Requirements
    1. CARF International
    2. The Joint Commission
    3. CQL The Council on Quality and Leadership
    4.  COA Council on Accreditation
    5. HFAP Healthcare Facilities Accreditation Program

III. CONSUMER ELIGIBILITY AND ENROLLMENT

  1. Consumer Eligibility, Enrollment/Registration and Benefit Groups
  2. Functional Standardized Assessments of Consumers Overview
    1. Level of Care Utilization System (LOCUS) 
    2. CIS-Columbia Impairment Scale 
    3. Ohio Scales
    4. DECA - Devereux Early Childhhod Assessments 
  3. Notice of DHS Community - Based Service - Estimating MH Medicaid Spend-down Status (pdf)

IV. MENTAL HEALTH SERVICES

  1. Service Definitions and Requirements
    1. Rule 132 59 ILAC, effective December 13, 2012
    2.  Community Mental Health Providers (CMHP) Reimbursement-Service Definition and Reimbursement Guide (SDRG) 
    3. Community Based Services (Rule 132) - Training Presentations
    4. Rule 132 Questions and Answers
  2. Utilization Management Program
    1. Utilization Management Program
    2. Medical Necessity Criteria and Guidance Manual
  3. Capacity Grant Definitions and Requirements
    1. DMH Community Services Contract-Attachment B
  4. Forensic Services
    1. Fitness Restoration Manual (pdf)
    2. Forensic Handbook (pdf)(updated April2014)
  5. Child and Adolescent Services
  6. Pre-Admission Screening/Mental Health (PAS/MH)
    1. PAS/MH Contractor's Procedure Manual (pdf) 
  7. Title XX/ Donated Funds Initiative Program Manual
  8. Region I South Crisis Care System
    1. Policy and Procedures
  9. Northwest Crisis Care System

V. PROVIDER MONITORING

  1. FY 15 Provider Monitoring
    1. Provider Monitoring External Protocols
    2. Post-Payment Review Tool
    3. Post-Payment Review Interpretive Guidelines
    4. CST Review Tool
    5. CST Interpretive Guidelines
    6. ACT Review Tool
    7. ACT Instructions
    8. CPG Tool
    9. CPG Tool Interpretive Guidelines
    10. Plan of Improvement Template
  2. Provider Complaints and Appeals
    1. Medicaid - 59 ILAC 132.44


VI. CONSUMER REGISTRATION FOR COMMUNITY SERVICES

  1. DHS/DMH Consumer Registration Requirements
    1. Illinois Mental Health Collaborative for Access and Choice - Batch Registration for Providers with their own software or third party software 
    2. Illinois Mental Health Collaborative for Access and Choice - Provider Connect Registration for Providers using DMH/Collaborative Software 

VII. CLAIMS SUBMISSION FOR DMH SERVICES 

  1. HFS Claims Submision Information

VIII.PRE-ADMISSION SCREENING/ MENTAL HEALTH 

  1. PAS/MH Contractor's Procedure Manual 

IX. SASS CLAIMS SUBMISSION 

  1. Screening, Assessment and Support Services


X. ICG

  1. ICG Services Manual (pdf)
  2. ICG Claims (Refer to Claims section)
  3. 59 ILAC 135
  4. Eligibility Criteria for the Individual Care Grant
  5. Frequently Asked Questions - ICG 

XI. WILLIAMS CONSENT DECREE 

  1. Williams Vs. Quinn 
  2. Resource Directory and Guide (RDG) for Williams Transition Coordinators 
  3. Individualized Comprehensive Service Plan Guide


XII.  Specialized Mental Health Rehabilitation ACT of 2013 Comparable Services

XIII. Important Reference and Resource Documents

  1. Illinois Statutes
    1. Mental Health and Developmental Disabilities Confidentiality Act 
    2. Mental Health and Developmental Disabilities
    3. Children's Mental Health Act of 2003 
    4. Public Act 097 - 0515, Disclosure for Treatment and Coordination of Care
    5. Public Act 097-0689 (SMART) Act 
    6. Illinois Mental Health Community Services Act (405 ILCS 30)
    7. Mental Health and Developmental Disabilities Administrative Act (20 ILCS 1705) 
    8. Title 59 Mental Health 
    9. Firearms Concealed Carry Act (Public Act 098-0063) 
      1. 59 IAC 150 Mental Health Reporting for Firearm Owner's Identification Card
      2. DHS FOID Mental Health Reporting Requirements 
      3. DHS FOID Mental Health Reporting
  2. Important Federal Policies, Regulations, and Reports
    1. Code of Federal Regulations (CFR) 
    2. United States Code (USC) 
    3. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) 
    4. Surgeon General's Report on Mental Health, 1999  
    5. President's New Freedom Commission's Report on Mental Health, 2003
  3. Illinois Provider Tools and Resources 
    1. Management Information System Resources Tool (pdf) 
  4. Evidence Based Practices:
    1. Dartmouth IPS Supported Employment Center 
    2. SAMHSA Registry of Evidence Based Practices
  5. Continuity of Care 
    1. Continuity of Care Strategic Planning Guidelines
    2. USARF for Adults (pdf) 
  6. Coordination of Benefits, Provider Requirements
  7. Performance Measures 
  8. HFS Medicaid Provider Handbooks
    1. HFS Medicaid Provider Handbook - Chapter 100
    2. HFS Medicaid Provider Handbook - Chapter 200
    3. HFS Medicaid Providers - Chapter 300 Electronic Processing

NOTE:  For accessible versions of any of these documents, please contact