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MVBCN Overview > FOR PROVIDERS > Provider Manual 

Provider Manual


Welcome to the on-line version of BCN's Provider Manual. We hope it includes all of the forms and policies you need as a BCN provider of Oregon Health Plan services, whether mental health or chemical dependency. The documents listed in RED apply only to the agencies which are contracted through us to provide mental health services. For other information or questions, check the staff directory to see which of our staff can help, and to obtain our contact information.


1. COD (Co-Occurring Disorders) Resources 1. COD (Co-Occurring Disorders) Resources
a. Practice Guidelines: Co-Occurring Disorders
b. Chart review protocol – April 2009 version
c. Confidentiality Protections for Individuals with Co-Occurring Disorders
d. Sample materials for agency personnel processes
e. Competency in the Treatment of Individuals with Co-Occurring Disorders
f. Dual Diagnosis Anonymous



RELATED DOWNLOADS [PDF]

Practice Guidelines: Co-Occurring Disorders PDF

COD chart review protocol – April 2010 (PDF)

Dual Diagnosis Anonymous of Oregon.PDF
   


2. Credentialing 2. Credentialing
a. Credentialing and Recredentialing Policy and Procedure
b. Credentialing for Adjunct Service Providers
c. Provider Re-Credentialing Application – for agencies
d. Holding Ourselves Accountable
e. 2010 Mental Health Agency Recredentialing Criteria



RELATED DOWNLOADS [PDF]

Credentialing and Recredentialing Policy and Procedure

Credentialing for Adjunct Service Providers

Provider Re-Credentialing Application – for agencies

Holding Ourselves Accountable PDF

2010 MH Recredentialing Criteria


3. Critical Incidents 3. Critical Incidents
a. Critical Incidents Policy and Procedure
b. Critical Incident Report Form
c. Regional Review of Client Deaths and Suicide Attempts



RELATED DOWNLOADS [PDF]

Critical Incident Report Form PDF

Critical Incidents Policy and Procedure PDF

Regional Review of Client Deaths and Suicide Attempts PDF
   


4. Member Rights and Responsibilities 4. Member Rights and Responsibilities
a. Member Rights and Responsibilities Policy
b. Confidentiality Protections for Individuals with Co-Occurring Disorders
c. Declaration for Mental Health Treatment Download Declaration from Oregon.gov website



RELATED DOWNLOADS [PDF]

Member Rights and Responsibilities Policy and Procedure PDF

Declaration for Mental Health Treatment PDF
     


5.  Grievance System Policy & Appendices (Approved 03-2009) 5. Grievance System Policy & Appendices (Approved 03-2009)
a. Grievance System Policy with Appendices
b. Our Process for Complaints & Feedback (English & Spanish)
c. OHP Complaint Form (English & Spanish)
d. Notice of Action Templates (2)
e. How to File an Appeal (English & Spanish)
f. Appeal Form (English & Spanish)
g. DMAP Notice of Hearing Rights



RELATED DOWNLOADS [PDF]

Grievance System Policy with Appendices

Our Process for Complaints & Feedback (English)

Our Process for Complaints & Feedback (Spanish)

OHP Complaint Form (English)

OHP Complaint Form (Spanish)

Notice of Action Template - For change to previously authorized services

Notice of Action Template - For denial of requested service/payment

How to File an Appeal (English)

Appeal Form (English)

Appeal Form (Spanish)

DMAP Notice of Hearing Rights (English)
       


6. Quality Management 6. Quality Management
a. Standards for Provider Quality Management Program


RELATED DOWNLOADS [PDF]

Quality Management PDF
       


7. Practice Guidelines 7. Practice Guidelines
a. Practice Guidelines: Co-Occurring Disorders
b. Practice Guidelines for Early Psychosis



RELATED DOWNLOADS [PDF]

Practice Guidelines: Co-Occurring Disorders PDF

Practice Guidelines for Early Psychosis PDF
     


8. Utilization Management Policy and Procedures 8. Utilization Management Policy and Procedures
a. Outpatient Services
b. Services to Members with Other Medical Conditions
c. Crisis and Emergency Services
d. Intensive Services Array for Children and Adolescents
     1. Admission Criteria
     2. Referral and Determination of Need
     3. Managing the Utilization of Intensive Services
     4. Criteria for Transition and Discharge from Intensive Services
e. Inpatient Psychiatric Services
     - Inpatient Services -- Expected Practices
     - Emergency Admission Criteria
     - Continued Stay Criteria

 




RELATED DOWNLOADS [PDF]

Personal Action/Crisis Prevention Plan (PDF)

Utilization Management Policy and Procedures PDF
     


9. PCP Communication 9. PCP Communication
a. PCP Communication policy


RELATED DOWNLOADS [PDF]

PCP Communication Policy (PDF)
       



  



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