Provider Manual

BHRS REPORTING REQUIREMENTS

Each of the counties managed by Beacon has assigned staff to complete the access tracking grid. The individual identified by the county collaborates with the Beacon CAFS Coordinator to ensure all members with an initial request for BHR Services appears on the access tracking grid. The access tracking grid is faxed or emailed to the Beacon Provider Field Coordinator by the last day of the following month. This grid records:

  • child’s name
  • date of the evaluation recommending BHRS
  • date the county received the evaluation
  • ISPT date
  • whether or not the evaluator participated in the ISPT
  • date of the 50th calendar day from evaluation
  • authorization date
  • whether or not an FBA was authorized
  • date services started
  • number of calendar days from the evaluation to the start of services
  • provider’s name
  • explanation for any delay in starting services (Beacon CAFS Coordinator will offer families choice of another provider and will assist families with choosing alternative providers when requested)

This grid provides the information necessary for Beacon to monitor whether any children have not been assigned or chosen a provider by the 50th day from the initial evaluation. All members with an initial request for BHR Services, regardless of whether or not they have chosen a provider, will be included on the access tracking grid.

This grid also provides the information for Beacon to monitor the timely access to BHR services 50 days from the initial evaluation date.

Beacon will monitor timely access to services in the following manner:

  • The Beacon Provider Field Coordinator will review the access grid completed by the county.
  • A sample of 20% of all initial requests for BHRS will be chosen per county (no less than two children) on a monthly basis.
  • A fax or email will be sent to the providers represented by the 20% sample. The fax will be a request for documentation verifying the date each service began (TSS, MT, BSC), or documentation that an attempt was made to begin services. A progress note will be requested for the date that each service began. If the provider attempted to begin service but could not due to the family’s choice, an explanation with a parent/guardian signature will be requested. The provider will be given within five calendar days to provide the response.
  • If the delay in the start of services was due to provider unavailability, the provider will be required to submit an explanation for the delay and a plan of correction within five calendar days of the request.
  • Beacon will monitor the corrective action plan and give a status update in the following month’s BHRS report.
  • Chart reviews will be conducted when a provider reports a delay in starting services of more than 50 days from the initial evaluation date, two or more times in a quarter. This on site review of medical records will examine additional charts to ensure timely access to BHR Services.

Quality of care issues that are noted during the BHR Services medical record review, will be referred to QOC for review and disposition, which may include additional quality and/or clinical chart audits.

Note: BHRS Forms may be downloaded at:
www.vbh-pa.com/providers/provider-forms