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Bulletin ID: No. 84 - Concurrent Review Guidelined


Tuesday, August 27, 2013

CBI CONCURRENT REVIEW REQUIRED DOCUMENTATION:

The concurrent review process is conducted by the Department of Mental Health Associate Chief Clinical Officer for Children and Youth or their designee.  Concurrent review is required for all CBI authorization requests after the initial 6 month time limit. The following items are REQUIRED for the Concurrent Review:

CURRENT DIAGNOSTIC ASSESSMENT – This assessment should not be more than one year old.  

CSA TREATMENT PLAN OF (IPC) – This document should be provided by the CSA of record for the consumer.  The most recent plan should be submitted and the need for CBI should be outlined.

CBI TREATMENT PLAN OF CARE – The CBI provider should submit the last two CBI treatment plans for the consumer.

COMPREHENSIVE CLINICAL PRESENTATION - This presentation needs to outline the CBI service provision over the last 6 months.  It should highlight progress towards goals, discuss any obstacles, strengths, achievements, hospitalizations, school or home placement disruptions, and areas of concerns that warrant continues CBI level intervention.

CALOCUS SCORE SHEET

Prior to submitting the concurrent review documentation the CBI reauthorization request must be entered into Provider Connect/eCura.  Please be sure to enter the Authorization Type (located in the CBI clinical event) as “Post 6 months.”

If the team has determined that they would like to request CBI services beyond the 6 month time limit, please complete the event and submit the required documentation at least 2 weeks prior to the expiration of the current authorization end date.  

The required documentation should be submitted to Allison Colombel via email allison.colombel@dc.gov fax at 202.481-3823.  

Once all required documentation is submitted, please allow up to five business days for processing and determination.
 

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