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PRIOR AUTHORIZATION INTENSIVE IN-HOME MENTAL HEALTH SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY

PRIOR AUTHORIZATION INTENSIVE IN-HOME MENTAL HEALTH SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY 2026

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The document provides instructions for the Prior Authorization Intensive In-Home Mental Health/Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment required by ForwardHealth in Wisconsin. It outlines the necessary information providers must submit to obtain authorization and reimbursement for services, emphasizing the importance of accurate member information and confidentiality. The document details the elements that need to be completed for initial and subsequent prior authorization requests, including member information, assessment details, treatment goals, and multi-agency coordination.

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Click ‘Get Form’ to open it in the editor.
Begin with Section I – Member Information. Enter the member’s name, date of birth, and identification number accurately using the ForwardHealth card or Enrollment Verification System.
Proceed to Section II – Initial Prior Authorization Request. Document the date of assessment, presenting problem, diagnoses, symptoms, and a strength-based assessment that reflects both current and historical data.
In Section III for Subsequent Requests, indicate any changes in previous elements and provide updated information as necessary.
Move to Section IV – In-Home Recovery/Treatment Plan. Clearly outline treatment goals and objectives while documenting how the member's strengths will be utilized.
Complete Sections V and VI by detailing multi-agency involvement and obtaining necessary signatures from certified professionals and the member or legal guardian.

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2019	4.8 Satisfied (146 Votes)
2012	4 Satisfied (20 Votes)

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What does a substance abuse assessment consist of?

Needs Assessment should answer the following questions: Who is the priority population? What are the needs of the priority population? Which subgroups within the priority population have the greatest need?

What are examples of needs assessment?

Needs Assessment focuses on the ends (i.e., outcomes) to be attained, rather than the means (i.e., process). For example, reading achievement is an outcome whereas reading instruction is a means toward that end. It gathers data by means of established procedures and methods designed for specific purposes.

What should a needs assessment include?

The DAST-10 (Drug Abuse Screening Test-10) is the shortened and more commonly used version of a 20-item (DAST-20) or the original 28-item version. The DAST is sometimes combined with the AUDIT or other alcohol screens to cover both alcohol- and drug-related problems.

What is a dual diagnosis mental health and AOD?

Dual Diagnosis is the term used to describe this relationship when someone is experiencing both mental health problems and alcohol and drug dependence. Examples of a Dual Diagnosis might include: a mental health problem that has led to a person becoming dependent on alcohol and/or drugs.

Should mental health and substance abuse be treated together?

Someone with a mental health problem and substance use disorder must treat both issues. Treatment for both mental health problems and substance use disorders may include rehabilitation, medications, support groups, and talk therapy.

What is a needs assessment for substance abuse?

A needs assessment Determines the need for crisis counseling, mental health and/or substance misuse treatment, public education, and information dissemination. Assesses risk factors and reactions in relation to: Safety.