Provider Handbook

General Information

 

Connect Care Staff Contact Information

 

Introduction

 

Mission/Vision Statement

 

 

 

 

Billing/Claims

 

CountyBilling Procedures

 

Authorizations/Vouchers

 

HCFA 1500 Form

 

HCFA 1500 Instructions

 

 

 

 

Contracts & Credentialing

 

Contracting

 

Credentialing/Recredentialing Requirements

 

Individual Credentialing Application

 

Individual Specialty Addendum

 

Organization Credentialing Application

 

Organization Staff Specialty Form

 

 

 

 

Documents

 

Clients Rights & Responsibilities

 

Comprehensive Audit Tool

 

Documentation Standards and Best Practices

 

Notice of Privacy Rights (English)

 

Notice of Privacy Rights (Spanish)

 

Provider Rights & Responsibilities

 

Qualified Service Organization Agreement (QSOA)

 

 

 

 

Forms

 

 

 

Comment/Complaint Form

 

W-9

 

 

 

 

 

Providers

 

 

ATR

 

 

 

Billing and Claims

 

 

 

Claims Procedures

 

 

Documents

 

 

 

Recovery Support Services Assessment Tool

 

 

 

Reimbursement Rates

 

 

Forms

 

 

 

Claims Appeal Form

 

 

 

Claims Appeal Instructions

 

 

 

Provider Manual

 

 

 

Provider Enrollment Application Instructions

 

 

 

Recovery Support Service Provider Application

 

 

 

Treatment Provider Application

 

 

 

 

 

El Paso County

 

 

Billing and Claims

 

 

 

Billing Procedures

 

 

Documents

 

 

 

Clinical Guidelines

 

 

 

Substance Abuse Core UM Plan

 

 

 

Performance Requirements DHS

 

 

Forms

 

 

 

Claims Appeal Form

 

 

 

Claims Appeal Instructions

 

 

 

Provider Qualification Form

 

 

 

Monthly Summary Form

 

 

 

Monthly Summary Instructions

 

 

 

 

 

Teller County

 

 

Billing and Claims

 

 

 

Billing Procedures

 

 

Documents

 

 

 

Clinical Guidelines

 

 

 

Performance Requirements DSS

 

 

Forms

 

 

 

Claims Appeal Form

 

 

 

Claims Appeal Instructions

 

 

 

Monthly Summary Form

 

 

 

Monthly Summary Instructions

 

 

 

 

 

Rural Counties (Chaffee, Custer, Fremont, Lake, Park)

 

 

Forms

 

 

 

Claims Appeal Form

 

 

 

Claims Appeal Instructions

 

MSO

 

 

 

Forms

 

 

 

Critical Incident Reporting Form

 

 

 

Critical Incident Reporting Instructions

 

 

Documents

 

 

 

All Hazards Disaster Response Plan

 

 

 

Clinical Delivery Information

 

 

 

Data Reporting Requirements

 

 

 

Encounter Requirements

 

 

 

Fiscal Report Requirements

 

 

 

Income Eligibility Guidelines

 

 

 

Payment Requirements

 

 

 

Treatment Outcome Requirements

 

 

 

Treatment Requirements

 

 

 

Substance Abuse Core UM Management Plan

Surveys

 

 

Sample Client Surveys

 

Sample Provider Surveys

Links

 

 

 

A Treatment Improvement Protocol - TIP 42

 

ColoradoAlliance for Drug Endangered Children

 

Colorado License Verification

 

Division of Behavioral Health

 

Interagency Committee on Adult and Juvenile Correctional Treatment (IACAJCT)

 

National Alliance for Drug Endangered Children

 

NIDA Principles

 

Office of the Inspector General - Exclusion List

 

SAMHSA

 

SAMHSA Principles of Women and Violence Study

 

Wellness is Our Job


Since 1875, Pikes Peak Behavioral Health Group has created help and hope for Colorado residents. We provide services to meet individual and family needs in mental health, substance abuse, vocational training and employment, education, and restorative justice. We also provide services to other mental health/substance abuse providers in our area.

(719) 572-6330 | (866) 940-3347 | Crisis: (719) 635-7000 | www.ppbhg.org | info@ppbhg.org

Copyright 2010, Pikes Peak Behavioral Health Group. Colorado Springs, Colorado