June 19, 2020
New Process - Child and Adolescent BHIF, BHRF and TFH prior authorization

Applicable to: Mercy Care Complete Care, Mercy Care RBHA, and Mercy Care DD
Effective Monday June 29th, 2020, Mercy Care is implementing new processes for Child and Adolescent Behavioral Health Inpatient Facilities (BHIF), Behavioral Health Residential Facilities (BHRF), Therapeutic Foster Home (TFH - previously known as HCTC) Prior Authorization requests and approvals.

Approved prior authorizations will be valid for 60 days from the date of determination. After that period, a new prior authorization request with current clinical information must be submitted.

Mercy Care respects member choice and will support all available options. However due to the treatment level of care required, there may not be a treatment provider available that has all of the members’ preferences.  If a member and/or guardian declines treatment when an available BHIF, BHRF, or TFH has been offered, it will be considered a withdrawal of the request for services.
If a member is already approved for a BHIF, BHRF or TFH admits to a higher level of care, such as a behavioral health inpatient hospital or sub-acute facility, the approval will be closed and a new application for BHIF, BHRF or TFH will need to be submitted with current clinical information.

Provider must fax in the admission face sheet with a minimum of member name, DOB, AHCCCS ID, facility name and address, Level of Care (BHIF,BHRF,TFH (HCTC)) Admit date and primary diagnosis to Mercy Care AZ Utilization Management Department Fax # 855-825-3165.

As always, don't hesitate to contact your Mercy Care Network Management 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!