Get Ucare Outpatient Review Form Mental Health And Ctss Services ... - Ucare

This guide provides clear and supportive instructions for completing the UCare Outpatient Review Form for Mental Health and CTSS Services. Following these steps will help you accurately provide the necessary information to ensure a smooth review process.

Follow the steps to complete the UCare Outpatient Review Form

1. Press the ‘Get Form’ button to access the document and open it in your chosen editing tool.
2. Fill out the member information section. Ensure all fields, including the member's name and ID, are accurate to verify eligibility.
3. Provide complete provider information. Enter the provider agency name, provider ID, therapist name, and contact phone number.
4. Indicate the requested sessions. Specify the desired dates of service, the total number of visits for each procedure code, and any other relevant information for CTSS services.
5. Document current psychotropic medications and agency involvement. Specify if medications are being prescribed and provide the prescriber's details.
6. Note any DSM-IV-TR diagnosis and indicate current risk indicators relevant to the member.
7. Evaluate the three significant objectives since treatment initiation. Use the provided scale to rate progress and fill in measurable details.
8. Complete the risk assessment section concerning suicidality and homicidality, noting any prior attempts and rating the member's level of psychological distress.
9. Indicate whether a crisis plan is in place if the psychiatric hospitalization risk is rated as moderate or higher.
10. Review the entire form for completeness and accuracy, then save your changes or choose to download, print, or share the document as needed.

Complete and submit the UCare Outpatient Review Form online today to ensure timely processing of mental health services.