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Archive of Provider Alerts

2017 Provider Alerts
PA17 Nov-10 Revised Rate Setting Policy [Except HealthChoices Northeast] 74 KB PDF
ADM017 Provider Rate Setting Policy and Procedure Manual 34 KB PDF
PA16 Oct-19 Treatment Plan Documentation Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) 74 KB PDF
PA15 Sept-01 Change in Authorization Process [Chester] 74 KB PDF
PA14 Aug-07 Change in Authorization Process 100 KB PDF
PA13 Jul-25 Change in Authorization Process [Allegheny] 75 KB PDF
PA12 Jun-21 PROMISe Enrollment Required for All Ordering, Referring, or Prescribing Practitioners
ORP Survey (XLSX, 11KB)
70 KB PDF
PA11 Jun-21 Peer Support Services - Youth 14 Years of Age and Older 76 KB PDF
PA10 May-24 Change of Address for Camp Hill Office [Adams/Berks/York] 73 KB PDF
PA09 Apr-28 Fraud, Waste & Abuse (FWA) Compliance & Program Integrity Update 71 KB PDF
PA08 Apr-28 Change in Authorization Process: Allegheny County Drug and Alcohol (ALDA) 59 KB PDF
PA07 Apr-28 Member Eligibility Verification Via ePortal 64 KB PDF
PA06 Apr-28 Change In Eligibility Process For Allegheny County Drug And Alcohol (ALDA) 65 KB PDF
PA05 Apr-21 Change in Precertification Process for Inpatient Non-hospital Detoxification (3A) Services 68 KB PDF
PA04 Mar-03 PROMISe Enrollment - Financial Impact 68 KB PDF
PA03 Feb-28 Change of Address for Williamsport Office [Lycoming/Clinton] 55 KB PDF
PA02 Feb-13 New Required Documents for Continued Stay Requests for Child/Adolescent Partial Hospitalization Programs (PHP) [York/Adams/Berks] 62 KB PDF
PA01 Feb-13 New Provider Manual 55 KB PDF

2016 Provider Alerts
PA16 Oct-12 Encounter Form Requirements 83 KB PDF
PA15 Oct-11 Enhanced Outpatient Services: Change in Authorization Rules [Allegheny] 210 KB PDF
PA14 Sep-30 Performance Standards for Psychiatric Rehabilitation Services 187 KB PDF
PA13 Sep-30 BHRS Providers: New Plan of Care Requirements for Applied Behavior Analysis (ABA) 73 KB PDF
PA12 Sep-30 BHRS Providers: New Billing Codes for Applied Behavior Analysis (ABA) [North East] 78 KB PDF
PA11 Sep-30 BHRS Providers: New Billing Codes for Applied Behavior Analysis (ABA) [Chester] 78 KB PDF
PA10 Sep-30 BHRS Providers: New Billing Codes for Applied Behavior Analysis (ABA) [All Counties except North East & Chester] 81 KB PDF
PA09 Sep-20 New Termination Procedure for Blended/Intensive/Resource Coordination Case Management for Adults and Child/Adolescents 405 KB PDF
PA08 Sep-06 Electronic Authorization Reports Replacing Paper Authorization Reports for Practitioners Effective September 19, 2016 301 KB PDF
PA07 Aug-02 Notification to North Central State Option Providers Regarding Revisions to TCM Performance Standards [North Central] 67 KB PDF
PA06 Aug-01 Community Care ePortal Users Required to Use Current Industry-Standard Web Browsers 94 KB PDF
PA05 Jul-08 Change in Frequency: Collection of Outcomes for Children and Families Receiving Behavioral Health Rehabilitation Services (BHRS) and Community and School Based Behavioral Health Services (CSBBH) 250 KB PDF
PA04 Jul-01 Training Requirements for Licensed Behavior Specialists Who Use Behavioral Specialist Consultant - Autism Spectrum Disorder Services to Provide Applied Behavior Analysis 243 KB PDF
PA03 Mar-10 HealthChoices Erie Initial ISPT Meetings for BHRS Services [Erie] 227 KB PDF
Mar-10 BHRS Capacity Report Template 12 KB XLSX
PA02 Feb-22 Prescription of Naloxone 90 KB PDF
PA01 Jan-25 January 28, 2016 Outpatient Registration & POMS Transition 85 KB PDF

2015 Provider Alerts
PA19 Dec-18 PROMISe Enrollment Application Submission Deadline Approaching 290 KB PDF
PA18 Dec-01 Change in Outpatient Registration Process for Practitioners 69 KB PDF
PA17 Nov-03 Change in Outpatient Registration Process for Facilities 258 KB PDF
PA16 Oct-28 Providers of Drug & Alcohol Services Coordination With Single County Authority (SCA) Offices [Lycoming/Clinton] 235 KB PDF
PA15 Sep-16 ICD-10 Implementation Reminders 255 KB PDF
PA14 Sep-16 Appropriate Use of Diagnosis Code F99 77 KB PDF
PA13 Aug-10 Providers of Drug & Alcohol Services Coordination with Single County Authority (SCA) Offices [North Central] 242 KB PDF
PA12 Aug-04 Interpretation Services [Erie] 237 KB PDF
PA11 Aug-04 Re-Enrollment/Revalidation of Medical Assistance Providers 215 KB PDF
PA10 Aug-04 Encounter Forms for Mobile Services 223 KB PDF
PA09 July-24 ICD-10 Implementation 86 KB PDF
PA08 July-24 Submitting Diagnoses on Authorization Requests 68 KB PDF
PA07 July-10 Change of Address for Community Care Administrative Office [Blair] 66 KB PDF
PA06 July-07 Changes to Online Authorization Request Forms 241 KB PDF
PA05 June-18 Coordination of Benefits Timely Filing Changes 74 KB PDF
PA04 June-18 Discontinuation of Paper Outpatient Registration Forms 68 KB PDF
PA03 May-05 Treatment Plan Definitions 78 KB PDF
PA02 Feb-24 Eligibility Changes Related to Healthy PA 237 KB PDF
PA01 Jan-14 Individuals Enrolled Incorrectly in Healthy PA Private Coverage Option (PCO) Plans 85 KB PDF

2014 Provider Alerts
PA12 Dec-16 Inpatient Performance Improvement Project 83 KB PDF
    Dennis Marion Letter to Inpatient Behavioral Health Providers 76 KB PDF
PA11 Dec-16 Certified Peer Specialist Performance Standards 68 KB PDF
PA10 Sep-18 Implementation Dates for ICD-10 and DSM 5 131 KB PDF
PA09 Aug-1 Change of Address for Community Care Administrative Office (Pittsburgh) 66 KB PDF
PA08 Apr-7 Inpatient Mental Health Evaluation Conducted by a Physician 72 KB PDF
PA07 Mar-25 Revised 1500 Claim Form 119 KB PDF
PA06 Mar-25 Collection of Outcomes for Children and Families Receiving BHRS [Lycoming, Clinton] 168 KB PDF
PA05 Feb-27 Collection of Outcomes for Children and Families Receiving BHRS [Blair] 167 KB PDF
PA04 Feb-25 Collection of Outcomes for Children and Families Receiving BHRS [Adams, Berks, York] 85 KB PDF
PA03 Feb-10 Collection of Outcomes for Children and Families Receiving BHRS [Carbon, Monroe, Pike] 85 KB PDF
PA02 Jan-7 Rate Setting Policies [Blair, Lycoming/Clinton] 307 KB PDF
    Provider Rate Setting Policies and Procedures 174 KB PDF
PA01 Jan-1 Collection of Outcomes for Children and Families Receiving BHRS [Erie, North Central] 85 KB PDF

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2013 Provider Alerts
PA12 Oct-30 Provider Reimbursement Phone Hours Change 191 KB PDF
PA11 Oct-15 Collection of Outcomes for Children and Families Receiving BHRS [Northeast] 87 KB PDF
PA10 Oct-01 Change in Authorization Process 192 KB PDF
PA09 Sep-06 HIPAA Privacy and Security Rules 419 KB PDF
PA08 Sep-06 Appropriate Use of Diagnosis Code 995.5 114 KB PDF
PA07 Aug-27 Child Outcomes Survey [Allegheny] 171 KB PDF
PA06 Aug-27 DSM 5 and ICD-10 473 KB PDF
PA05 Jul-30 Case Management and Crisis Auths 113 KB PDF
PA04 Apr-04 Electronic Auth Reports 100 KB PDF
PA03 Mar-01 Adverse Events 165 KB PDF
PA02 Mar-01 Access Standards 148 KB PDF
PA01 Jan-01 Provider Compliance Plans 104 KB PDF

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2012 Provider Alerts
PA16 Nov-20 Change in Mailing Address for Community Care Capital Office [York/Adams, Berks] 97 KB PDF
PA15 Oct-29 Screening For Co-Occuring Mental Illness and Substance Abuse Disorders [Allegheny; Carbon/Monroe/Pike; Erie; North Central; North East; York/Adams, Berks] 88 KB PDF
PA14 Sep-26 Prescribers and Providers of Children's Behavioral Health Services Coordination with CASSP [North East] 78 KB PDF
PA13 Sep-26 Notification Regarding Changes Related to Child/Adolescent Non-Acute Partial Hospitalization Program Services [Carbon/Monroe/Pike] 47 KB PDF
PA12 *Dec-07 Update from the Fraud, Waste, and Abuse Department
*Updated on Dec. 7, 2012
142 KB PDF
PA11
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PA10 Aug-30 Using Psychology Assistants for BP Evaluations/Re-evaluations 71 KB PDF
PA9 Aug-23 Performance Standards for Co-Occurring Disorder Competency 49 KB PDF
PA8 Jun-26 Erie County Timely File Reminder [Erie] 47 KB PDF
PA7 Jun-26 Continuity of Services for Transferring Individuals 65 KB PDF
PA6 Jun-26 Drug and Alcohol Level of Care Assessment [Allegheny] 158 KB PDF
PA5 Jun-05 ALDA Targeted Case Management [Allegheny] 50 KB PDF
PA4 May-31 Changes Related to Child/Adolescent Non-Acute Partial Hospitalization Program (PHP) Services [North Central] 50 KB PDF
PA3 Apr-16 Medicare Dual Eligibles - Inpatient Psychiatric Admissions [Allegheny] 50 KB PDF
PA2 Apr-4 Provider Online [Allegheny] 80 KB PDF
PA1 Mar-1 HealthChoices Rate Setting Policies 86 KB PDF
Erie County 30 KB PDF

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2011 Provider Alerts
PA9 Nov-30 HIPAA 5010 Implementation Reminder 50 KB PDF
PA8 Oct-28 Guidelines to Ensure Affirmative Environments and Clinically Appropriate Services for LGBTQI Consumers and their Family Members 48 KB PDF
PA7* Mar-30 March 30 Letter to Providers 64 KB PDF
Mar-30 BMI & Beyond Webinar
Jan-06 January 6 Letter to Providers 21 KB PDF
Jan-06 Assessment and Monitoring of Weight and other Physical Health Indicators 74 KB PDF
PA6 Sep-22 Provider Screening for Employees and Contractors 464 KB PDF
PA5 Jun-16 Fraud, Waste, and Abuse Department Update 70 KB PDF
PA4* Nov-23 Clarification on Changes Regarding Partial Hospitalization Services [North East] 53 KB PDF
PA4 Jun-15 Changes Regarding Partial Hospitalization Services [North East] 41 KB PDF
PA3 Mar-29 New Physical Health/Behavioral Health Monitoring 35 KB PDF
PA2 Feb-23 Precertification of Psychological and Neuropsychological Testing: Change in Fax/Authorization Procedure 33 KB PDF
PA1 Feb-23 Enhanced Outpatient Services: Change in Administrative Rules [Allegheny] 40 KB PDF

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2010 Provider Alerts
PA12 Dec-03 New Plan of Care Summary form for all BHRS Programs 39 KB PDF
PA11 Oct-18 Family Based Mental Health Services Submission of Treatment Plans and Crisis Plans 35 KB PDF
PA10 Oct-01 Outpatient Psychiatric Services 35 KB PDF
PA9 Aug-24 Provider of Drug & Alcohol Services Coordination with Single County Authority (SCA) Offices [North Central] 39 KB PDF
PA8 Aug-10 Change in Assessment and Identification of Service Coordination Needs for Children and Adolescents [Allegheny] 36 KB PDF
PA7 Aug-01 Change in Timeframes for BHRS Services 34 KB PDF
Aug-01 OMHSAS-10-04 Bulletin 175 KB PDF
PA6 Jun-04 Provider Reporting of School Based Services 37 KB PDF
Jun-04 PA Public School Codes 663 KB PDF
PA5 May-26 Time Sensitive Provider Survey - LGBTQI 52 KB PDF
May-26 LGBTQI Survey 40 KB PDF
PA4 May-01 Peer Support Services - Change in Authorization Procedure 55 KB PDF
PA3 Apr-01 Notification Regarding Changes Related to Child and Adolescent Acute and Non-Acute PHP Services [York/Adams, Berks] 62 KB PDF
PA2 Jan-29 Crisis Authorizations 40 KB PDF
PA1 Jan-21 Access Standards 41 KB PDF

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2009 Provider Alerts
PA12 Nov-25 Verbal Notice of Utilization Review Decisions [HealthChoices and ALDA] 26 KB PDF
PA11 Nov-18 Rate Setting Policies 60 KB PDF
    Allegheny, York/Adams, Berks
Chester, North Central, Carbon/Monroe/Pike

Northeast
60 KB
23 KB

23 KB
PDF
PDF

PDF
PA10 Aug-18 Appropriate Use of Diagnosis Code 799.9 25 KB PDF
PA9 Aug-18 DPW/OMHSAS Approved Definition of Medical Necessity Criteria 32 KB PDF
PA8 Jun-24 Recovery Oriented Systems Indicators (ROSI) Administrative Measures [North East] 31 KB PDF
PA7 May-29 Coordination with CASSP [North Central] 31 KB PDF
    County CASSP & Children's Mental Health Coordinators [North Central] 76 KB PDF
PA6 Mar-25 STAP & Group Treatment Programs vs. TSS Workers Meeting in Groups with Consumers 56 KB PDF
PA5 Mar-19 Coordination of Benefits Discharge Review 24 KB PDF
PA4 Jan-29 Claims Required Fields Reminder 25 KB PDF
PA3 Jan-26 Timely Filing Changes for Claims Processing [North Central and Carbon/Monroe/Pike] 24 KB PDF
PA2 Jan-1 Community Care Clinical Forms Available Online 24 KB PDF
PA1 Jan-1 Functional Behavioral Assessment Training For Behavior Specialist Consultants 29 KB PDF

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2008 Provider Alerts
PA23 Oct-27 New Plan of Care Summary Forms for BHRS Programs 34 KB PDF
PA22 Oct-27 Updated ISPT Summary & Prescriber Collaboration Form 27 KB PDF
PA21 Oct-27 TSS Schedule Forms 26 KB PDF
PA20 Oct-27 New RTF/IRT/CRR/TFC Plan of Care Summary Forms 26 KB PDF
PA19 Oct-27 New BP Evaluation Authorization Request Forms 25 KB PDF
PA18 Oct-10 Corrections on Remit Copies NOT Accepted After October 31, 2008 [HealthChoices and ALDA] 39 KB PDF
PA17 Sep-22 Notification to BHRS, RTF, IRT, CRR, and TFC Providers Regarding Delivery of Service Request Packets 28 KB PDF
PA16 Aug-25 BHRS Performance Standards for Autism Spectrum Disorders 26 KB PDF
PA15 Jul-24 Functional Behavioral Assessment Training 26 KB PDF
    Functional Behavioral Assessment Training Form 15 KB PDF
PA14 Jul-24 FBI Background Check Requirements 58 KB PDF
PA13 Jul-10 Interpreter Services [York/Adams, Berks] 30 KB PDF
PA12 Jun-25 Work Ready Pilot Program [Allegheny and ALDA] 26 KB PDF
    Sample Medical Assessment Form PA 635 333 KB PDF
PA11 Jun-12 Community Support Plan Helpline [Allegheny] 25 KB PDF
PA10 Jun-05 NPI Claims Submission 28 KB PDF
PA9 Apr-24 Claims Training 36 KB PDF
    Claims Training Schedule 40 KB PDF
PA7 Mar-28 Important Claims Information 38 KB PDF
PA6 Mar-05 Implementation of ISPT Meeting Attendance Request Form 34 KB PDF
PA5 Feb-13 Revision of Life Domain Format 34 KB PDF
PA4 Feb-08 Provider Online [HealthChoices and ALDA] 28 KB PDF
PA2 Jan-23 Change in POMS Submission 28 KB PDF
PA1 Jan-10 Access Standards [Carbon/Monroe/Pike] 33 KB PDF

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2007 Provider Alerts
PA17 Dec-27 Consumer/Family Satisfaction Team [North Central] 52 KB PDF
PA16 Dec-14 Authorization Process Revisions 89 KB PDF
PA15 Dec-13 Update Regarding The New Claims System 27 KB PDF
PA14 Dec-13 New Clinical Practice Guideline 27 KB PDF
PA13 Oct-10 Reporting of Significant Member Incidents for Residential Treatment Facilities 35 KB PDF
PA12 Nov-6 Outpatient Attendance Verification 35 KB PDF
PA11 Aug-8 Claims Training For New Claims System 618 KB PDF
PA10 Jun-8 Important Time Frame Change for Reporting Significant Member Incidents 36 KB PDF
PA8 May-17 National Provider Identifier (NPI) Claims Submission 27 KB PDF
PA7 May-4 New Claims System 58 KB PDF
PA6 Apr-24 Clinical Practice Guidelines 26 KB PDF
PA5 Feb-27 Criteria for Inpatient Services 53 KB PDF
PA4 Feb-8 Reporting Your NPI to Community Care 44 KB PDF
PA3 Jan-31 Access Standards [Northeast] 41 KB PDF
PA2 Jan-22 RTF Child Abuse Clearances & Criminal Record Checks 25 KB PDF
PA1 Jan-18 Prescriber Responsibilities if Using Assistants for BP Evaluations 62 KB PDF

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2006 Alerts
PA14 Feb-27 North Central Claims System 32 KB PDF
PA13 Feb-8 Notification Regarding Change to BHRS ISPT Meeting Attendance Request Form 39 KB PDF
PA12 Jan-31 Notification Regarding Change to BHRS Authorization Requests 38 KB PDF
PA11 Jan-22 Notification Regarding Changes to the Admission/Discharge Notification Form and the Discharge Summary Form for Residential Treatment Facilities (RTF), Individual Residential Treatment (IRT), Therapeutic Foster Care (TFC), and Community Rehabilitation Residential (CRR) Programs 43 KB PDF
PA10 Jan-18 Care Management/Utilization Management Discharge Review Process 29 KB PDF
PA9 Feb-27 Requirement to Invite Care Managers to all initial RTF and BHRS Interagency Service Planning Team (ISPT) Meetings 49 KB PDF
PA8 Feb-27 Notification To BHRS and RTF Providers Regarding Delivery of Service Request Packets 36 KB PDF
PA7 Feb-8 Changes to Authorization of PHP/D&A IOP Services 49 KB PDF
PA6 Jan-31 Screening MISA 59 KB PDF
PA5 Jan-22 New Forms for RTF, IIRT, CRR, TFC 61 KB PDF
PA4 Jan-18 Guidelines for changing RTF Treatment 66 KB PDF
PA3 Jan-18 Domestic Violence 60 KB PDF

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2005 Alerts
PA12 Feb-27 Clinical Practice Guidelines 30 KB PDF
PA11 Feb-8 Claims Secondary Billing 62 KB PDF
PA9 Jan-31 Autism Bulletin 70 KB PDF
PA8 Jan-22 Neuropsych Testing 35 KB PDF
PA6 Apr-22 Provider Billing and Finance 78 KB PDF
PA5 Apr-7 MISA 60 KB PDF
PA4 Jan-18 Enhanced Outpatient Services 76 KB PDF
PA3 Apr-7 Pre Release Medicaid 38 KB PDF
PA2 Jan-18 Act 147 Information 39 KB PDF
PA1 Dec Allegheny Fee Schedule Reminders 63 KB PDF
PA1 Dec HealthChoices Adams, Berks and York Fee Schedule Reminders 63 KB PDF
PA1 Dec HealthChoices Chester Fee Schedule Reminders 63 KB PDF

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2004 Alerts
PA19 Dec-10 Notification Regarding Health Choices Behavioral Health Expedited Enrollment 73 KB PDF
PA17 Nov-4 Clarification of Requirements for Best Practice/Life Domain Evaluations and Doctoral Level BSC Services 59 KB PDF
PA15 Oct-27 Providers Required To Notify Community Care of Changes 44 KB PDF
PA14 Sep-21 New FAX Number for the Claims Department 34 KB PDF
PA12 Aug-5 New BHRS Monthly reporting as outlined in the July 1, 2004 OMHSAS letter. 48 KB PDF
PA11 Aug-4 Introduction to ePOWER 37 KB PDF
PA10 May-26 New FAX Number for the Claims Department 36 KB PDF
PA8 May-2 Update/Reminder on PROMISe Conversion with Community Care 37 KB PDF
PA7 May-2 Coordination of Benefits (COB) – HealthChoices Program 91 KB PDF
PA6 Apr-15 PROMISe Conversion with Community Care 48 KB PDF
PA5 Mar-3 “Service Class” Authorization Process 140 KB PDF
PA2 Feb-3 Preparation for the PA Department of Public Welfare's PROMISe Conversion 73 KB PDF
PA1 Feb-3 Web Based Outpatient Registration 71 KB PDF

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2003 Alerts
  Dec-15 HealthChoices HIPAA Standardized Code Sets Implementation 29 KB PDF
Jul-7 Reminder Regarding Parent/Guardian/Member Signatures on Forms 54 KB PDF
Jul-1 Outpatient Registration Instructions and Notification 68 KB PDF
May-16 MA Provider Type 41 – Psychologist Fee Schedule 52 KB PDF
  Apr-8 Email Distribution Request 35 KB PDF
  Apr-8 Coordination of Benefits (COB) – HealthChoices Program 84 KB PDF
Feb-10 Performance Improvement Plan for Residential Treatment Facilities Allegheny County 66 KB PDF
Jan-27 Provider Obligations to Report Changes 37 KB PDF
Jan-7 UPMC for You 39 KB PDF

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