Mercy Maricopa Integrated Care and Mercy Care Plan Long Term Care would like to provide some additional clarification on documentation requirements for Behavioral Health Residential Facility (BHRF) providers. BHRF is a 24 hour therapeutic living environment. As such, documentation of the member being present in the facility 24 hours per day is expected. Documentation during each shift (even while the member is sleeping) supports the per diem billing by noting the member's presence in the facility. Documentation is expected during the entire 24 hour period. If the member is offsite on a pass or AWOL, these instances should be documented for coordination of care purposes. If shift notes or other documentation is not present reflecting a 24 hour presence in the facility, the entire day of billing will be counted as an error on audits.
In addition, start and stop times are required to be present on all documents including notes for therapeutic services occurring in the facility. This is helpful in determining the total time members are spending in therapeutic activities during the day and is important for coordination of care purposes. The lack of start and stop times may result in errors on audits as well for the per diem billing period.
These items were noted as trends in recent audits. Clarification was obtained from the AHCCCS OIG to ensure that the requirements were what they expect and what they have expected for BHRF providers in the past.
As always, don't hesitate to contact your Mercy Care or Mercy Maricopa Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care or Mercy Maricopa website.
Thanks for all you do!
QB 3238
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