Get Bcn Behavioral Health Ip/php/iop Concurrernt Review Form

This guide provides a comprehensive overview of the BCN Behavioral Health IP/PHP/IOP Concurrent Review Form, helping users navigate each section effectively. By following the outlined steps, users can ensure accurate and successful completion of the form online.

Follow the steps to successfully fill out the BCN Behavioral Health form online.

1. Click ‘Get Form’ button to obtain the form and access it in your preferred editing tool.
2. Begin by entering the member number and facility name at the top of the form. This information is essential for identifying the case and relevant facility.
3. Fill in the member's name and the reviewer's name. Ensure that all names are spelled correctly to avoid any discrepancies.
4. Specify the review date to document when the review is taking place. This provides a clear timeframe for the review process.
5. Indicate the level of care, selecting from inpatient (IP), partial hospitalization program (PHP), or intensive outpatient program (IOP). This choice is crucial for the review's context.
6. Record the date of admission to provide the review team with background information on the member's treatment timeline.
7. For PHP and IOP, specify the number of days the member attended since the last review, noting the progression of treatment.
8. Provide the attending psychiatrist's name and the primary care practitioner's name, ensuring both names are included to maintain communication.
9. Document the date of any offered or signed releases of information, along with the corresponding dates of communication with the primary care practitioner, as this is important for compliance.
10. In the section regarding the member’s legal status, clearly indicate whether the member is voluntary or involuntary and fill in necessary guardian information if applicable.
11. Present justification for continued stay by checking responses to items regarding acute suicidal ideation, homicidal ideation, psychosis, detox symptoms, and any other relevant health indicators.
12. Include information about current diagnosis codes and other relevant medical history to support the justification for continued treatment.
13. Fill in the discharge section by anticipating a date of discharge, any additional days requested, and the discharge plan, as well as any barriers to discharge.
14. Indicate follow-up appointments, providing the provider name, contact number, date, and time to ensure continuity of care post-discharge.
15. Once all sections are completed, review the information for accuracy and completeness. You can then save your changes, download, print, or share the form as needed.

Complete your BCN Behavioral Health IP/PHP/IOP Concurrent Review Form online today to support effective treatment management.