Get Dbhdd Change Of Information Form

You will submit either the I/DD or BH Agency Provider Letter of Intent (LOI) or I/DD Individual Provider LOI during the applicable open enrollment period. You may access this form here: https://.georgiacollaborative.com/providers/forms/. Once the LOI has been approved, you will receive an invitation to apply.

How can we help? Call Us. Primary: (404) 656-4507. Visit.

The Notice of Privacy Practices (HIPAA Policy 23-101) is official notification from the Department of Behavioral Health and Developmental Disabilities (DBHDD) about the rights each individual has as a person seeking or receiving services.

In the state of Georgia, there exists a legal document called a 1013 form. The purpose of the 1013 form is to initiate transportation to an “emergency receiving facility” and is completed by an authorized licensed clinician.

O.C.G.A. § 37-3-41(a). A form 2013 is used when the basis of the need for services is based on a substance use disorder. The second source of authority for involuntary examination is by court order.

Mental Health (MH) and Substance Use Disorder (SUD): The Georgia Department of Community Health (DCH) oversees the state Medicaid program. The state does not have a relevant section 1115 waiver that affects reimbursement of residential services in Institutions for Mental Diseases (IMDs).

DBHDD Constituent Services: (404) 657-5964. The State's Office of Regulatory Services: (404) 657-5726 or (404) 657-5728. The Joint Commission's Office of Quality Monitoring: call (800) 994-6610 or email complaint@jcaho.org.