September 14, 2018
Behavioral health inpatient admission triage line change

Applicable to: Mercy Care Complete Care, Mercy Care RBHA, and Division of Developmental Disabilities
Effective September 17, 2018, Mercy Care is removing the behavioral health admission notification triage line that was in place for Mercy Care RBHA.

Providers will no longer have the option of calling in an inpatient behavioral health notice of admission. A dmission face sheets will need to be faxed to 855-825-3165.  To ensure authorizations are provided timely, faxes should to be sent in within one calendar day of the admission.  Inpatient behavioral health reviews will be completed in accordance with the AMPM Policy 1020-1

Policies and procedures for the concurrent review process must:
  1. Include relevant clinical information when making hospital length of stay decisions. Relevant clinical information may include but is not limited to symptoms, diagnostic test results, diagnoses, and required services.
  2. Specify timeframes and frequency for conducting concurrent review and decisions:
  • Authorization for institutional stays that will have a specified date by which the need for continued stay will be reviewed.
  • Admission reviews must be conducted within one business day after notification is provided to the Contractor by the hospital or institution (this does not apply to pre-certifications) (42 C.F.R.456.125)”.

We apologize for the inconvenience of sending this late notification to you and greatly appreciate your patience regarding this change. 
As always, don't hesitate to contact your Mercy Care Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website .

Thanks for all you do!