RUHSBH INPATIENT PROVIDER MANUAL

Welcome to the Riverside University Health System – Behavioral Health Plan provider network. The Behavioral Health Plan authorizes inpatient services through the Quality Improvement Inpatient Program for Riverside County Medi-Cal beneficiaries and for indigent Riverside County residents.

The Riverside University Health System – Behavioral Health Inpatient Provider Manual was developed as a reference for participating providers and contains guidelines to assist you in meeting the standards for the provision of psychiatric inpatient hospital services for our consumers. Please review the manual and maintain it as a reference for future use. We look forward to working with you to provide quality, cost effective inpatient services to our consumers. If you have any questions, please call Quality Improvement Inpatient Program at (951) 358-6031.

Inpatient Provider Manual Attachments

• Attachment A - 24-Hour Inpatient Notification
• Attachment B - 24-Hour Notification Correction Request
• Attachment C - Indigent Screening Form: Adult
• Attachment D - Indigent Screening Form: Minor
• Attachment E - Inpatient TAR Processing Requirements
• Attachment F - Specialty Mental Health Inpatient Services ICD-10 Covered Diagnoses Table
• Attachment G - Medical Necessity Documentation and Guidelines for Inpatient Providers (Acute Days)
• Attachment H - Documentation of Administrative Days for Inpatient Providers
• Attachment I -  Notice of Adverse Benefit Determination (NOABD)
• Attachment J - Inpatient Psychiatrist CPT Codes
• Attachment K - Indigent Notification and TAR
• Attachment L - California Guidelines for the Use of Psychotropic Medication with Child and Youth in Foster Care
• Attachment M - Parameters 3.8 for Use of Psychotropic Medication in Children and Adolescents
• Attachment N -  Medication Declaration Fax Cover Sheet
• Attachment O-1 - JV 220
• Attachment O-2 (S) - JV220 (Spanish)
• Attachment P-1 - JV 220A
• Attachment P-2 (S) - JV-220A (Spanish)
• Attachment Q-1 - JV-221
• Attachment Q-2 (S) - JV-221 (Spanish)
• Attachment R-1 - JV-223
• Attachment R-2 (S) - JV-223 (Spanish)
• Attachment S-1 – “Your Right to Make Decisions About Medical Treatment”
• Attachment S-2 – “Your Right to make Decisions About Medical Treatment” (Spanish)