What are the timeframes for completion of the behavior management plan following authorization of therapeutic behavioral services-development?
The APS consultative review protocol indicates that a plan (or documentation that plan development is initiated but has not yet been completed) must be present during the first 30 days of the authorization cycle. While it is understood that not every plan can be completed within 30 days, there should be documentation of progress related to plan development. APS established these time frames based on current provider practice, best practices, utilization guidelines and interpretation of the intent of the definition in the clinic and rehabilitation manuals per contract management. Based upon the requirements of this service, it has been determined that when this service is requested and authorized as medically necessary, there should not be a significant delay in provision of the service to the client.
