Thursday, June 28, 2012

Who Needs This?: Flow Diagram for How To Get Paid for Rendering Outpatient Mental Health Services at WHN or any Other LME in NC


This is the procedure, as per WHN LME, in order that Medicaid clients receive outpatient mental
health services: http://www.westernhighlands.org/images/stories/EnrollmentRegistrationFlow.pdf

1. Provider submits Enrollee 
registration Form (ERF)
and faxes to WHN

2. WHN 
e-mails WHN Client ID
(and Referral Number, if
requested) to provider

3. Provider completes/submits
STR, LCAD, TAR, & Tx Plan*
to WHN (within five days of first
contact with client)
electronically (CCIS)

4. WHN 
UM Staff manages
authorization

5. Provider receives authorization 
approval or denial (via LON)
and initiates services if approved.
___________________________________________

AND YOU CAN BET THAT ALL OF THIS HAS TO BE DONE AGAIN IN 3 MONTHS OR SO.....ALL OVER AGAIN.

Who needs this?

Give us a ONE PAYER SYSTEM, PLEASE SIR.

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