Notices and Letters



Notices and Letters Managed Care Provider Network Recruitment Outreach Letter BHCS is seeking qualified individual practitioners and groups of individual practitioners, such as licensed clinical social workers (LCSW), licensed marriage and family therapists (MFT) and licensed clinical psychologists (Ph.D./Psy.D.), to join BHCS’ Managed Care Individual Provider Network. Managed Care Provider Network FAQ's Read more about the Individual Provider Network. Individual Provider Network Brief Application. FY 12/13 Contract documents, as listed in your contract renewal package, are due no later than June 30th, 2012 to contracts@acbhcs.org The Annual Assessment Regarding Co-Occurring Informed Practice and Housing/Living Situation for FY 11/12 is due no later than 5:00 pm on Tuesday July 10, 2012. To complete the Assessment, visit: https://www.surveymonkey.com/s/AnnualAssessment Level One Provider Letter for AB109 Referrals Level Two Provider Letter for AB109 Referrals SUD Provider Letter for AB109 Referrals AB109 Client Intake and Progress Form InSyst Data Input Deadlines for FY11/12 Master Contract Template (revised May 2012) The Master Contract Template is on hold pending review. The timeline for implementation is suspended until further notice. Cash Advance Policy Cash Advance Form Instructions to Complete Exhibit B-1 for Mental Health Providers Exhibit C-2C: Insurance Requirements for For-Profit Health Care Services Exhibit C-4: Insurance Requirements for Non-Profit Health Care Services Exhibit C-13A: Insurance Requirements for Medical Services Providers Request for Insurance Waiver or Change (revised Jan 2008) Exhibit D: Audit Requirements (revised May 2012) Exhibit E: Business Associates Provisions (HIPPA) Exhibit F: Debarment and Suspension Certification Provider Claim/Service Report Instructions for Mental Health Programs Co-Occurring Conditions Contract Expectations Housing/Living Situation Conditions Contract Expectations Network Office Spring Provider Meeting _FY12-13_AOD Network Office Spring Provider Meeting_FY12-13_MH FY 11/12 Annual Assessment Regarding Housing/Living Situation and Co-Occurring Conditions Template FY 11/12 Contractor FAQs for Annual Assessment Regarding Housing & Co-Occurring Conditions’ Co-Occurring and Housing Summary - FY10/11 10-07-11 MH Cost Report Letter – FY10-11 10-07-11 Draft MH Template State Admin Requirements 05-27-11 AOD Provider Letter 05-27-11 InSyst Data Input Deadline Invoice Processing Deadline 05-27-11 MH Provider Letter 06-27-11 AOD Contract Renewal Letter FY 11/12