Facilities and Supportive Placement Specialization Survey |
Instructions
AHCCCS in partnership with its contracted health plans, has developed a survey for providers who manage Behavioral Health Residential Facilities (BHRFs) and Residential Treatment Centers (RTCs). The survey is to obtain information about the capacity of these providers to service individuals with complex health care needs. In addition, we are developing an online resource that will use this information to identify placements for members with complex needs.
What information will I need to complete the survey?
The survey asks for information about your organization (for example, ‘Tucson Care, LLC’) and about each BHRF or RTC’s location owned by Tucson Care (for Example, ‘TC1’, ‘Tucson Care on Main’) (Note: We are only asking about locations licensed as BHRFs or RTCS, do not enter anything for any other facilities)
For the organizational information, you will need the name and Tax ID of the organization, and the name and contact information for the person completing the survey, and the contact information for the facility for making referrals/placements.
For each location, you will need its service address, AHCCCS Provider ID, licensing category, Facility Provider Type, total and open beds, who the facility is contracted with, and information about specialized populations afforded care at the facility
What if I don’t know a facility’s AHCCCS Provider ID, licensing category or AHCCCS Provider Type?
The AHCCCS provider ID is a 6-digit number assigned by AHCCCS when you registered with AHCCCS. You can find it by logging into the AHCCCS provider portal at: https://azweb.statemedicaid.us/Account/Login.aspx?ReturnUrl=/
What information will I need to complete the survey?
The survey asks for information about your organization (for example, ‘Tucson Care, LLC’) and about each BHRF or RTC’s location owned by Tucson Care (for Example, ‘TC1’, ‘Tucson Care on Main’) (Note: We are only asking about locations licensed as BHRFs or RTCS, do not enter anything for any other facilities)
For the organizational information, you will need the name and Tax ID of the organization, and the name and contact information for the person completing the survey, and the contact information for the facility for making referrals/placements.
For each location, you will need its service address, AHCCCS Provider ID, licensing category, Facility Provider Type, total and open beds, who the facility is contracted with, and information about specialized populations afforded care at the facility
What if I don’t know a facility’s AHCCCS Provider ID, licensing category or AHCCCS Provider Type?
The AHCCCS provider ID is a 6-digit number assigned by AHCCCS when you registered with AHCCCS. You can find it by logging into the AHCCCS provider portal at: https://azweb.statemedicaid.us/Account/Login.aspx?ReturnUrl=/
Under the licensing category we are asking you for the general description of how the facility is licensed with ADHS. Is it licensed as a BHRF or an RTC?
AHCCCS provider type is also selected at the time of AHCCCS registration, but the provider types for RTCs and BHRFs are:
B1 – “Residential Treatment Center Secure (17+Beds) (IMD)”
B2 – “Residential Treatment Center Non-Secure” (1-16 Beds)
B3 – “Residential Treatment Center Non-Secure (17+Beds)
B8 – Behavioral Health Residential Facility (BHRF)
78 – Mental Health Residential Treatment Center
“Total licensed capacity” vs. “beds open at this facility”
The survey asks for total licensed capacity – the total number of beds you licensed with ADHS. It will also ask you for home many beds are open at each facility – as of the most recent data you have, how many do not have people in them and are available for a patient.
You will have the ability to enter multiple facilities for your organization. After completing the first survey, you will be asked to add information on any additional facilities managed by your organization.
AHCCCS provider type is also selected at the time of AHCCCS registration, but the provider types for RTCs and BHRFs are:
B1 – “Residential Treatment Center Secure (17+Beds) (IMD)”
B2 – “Residential Treatment Center Non-Secure” (1-16 Beds)
B3 – “Residential Treatment Center Non-Secure (17+Beds)
B8 – Behavioral Health Residential Facility (BHRF)
78 – Mental Health Residential Treatment Center
“Total licensed capacity” vs. “beds open at this facility”
The survey asks for total licensed capacity – the total number of beds you licensed with ADHS. It will also ask you for home many beds are open at each facility – as of the most recent data you have, how many do not have people in them and are available for a patient.
You will have the ability to enter multiple facilities for your organization. After completing the first survey, you will be asked to add information on any additional facilities managed by your organization.