Intakes / Referrals
It is the policy of Sunrise Health Clinics to ensure appropriate, adequate, and medically necessary services. Sunrise Health Clinics requires all staff to adhere to standards for care to include preliminary plans of care, treatment, and services. We’ll conduct a complete screening and assessment, then create a care plan that you lead with an emphasis on prevention and wellness.
Entry to Care, Treatment, or Services
Welcome! Sunrise can receive new clients entering into care, treatment, or services by referral via email to email@example.com, fax (702) 463-1851, or telephone correspondence (702)-209-0370. A licensed Sunrise Intake Coordinator or licensed clinician returns a call within 24-48 hour. On the phone, there is an initial pre-screening. We explain the intake process, obtain insurance and demographic information that is entered into our HIPAA compliant and secure EHR. Staff explains the type and structure of services, basic company policies, and general information regarding Sunrise. We offer clients the choice to receive services. If agreed, we continue the intake process. After checking insurance eligibility, we let clients know if charges might be applicable or if the insurance is not accepted. Once approved, we begin!
Clinical Team Philosophy and Pre-Screening and Consent Member Obtains General Information and Consent
A clinical team member reviews all policies, procedures, and consent forms with the client or guardian, if applicable. The referred client and/or guardian complete the consent form packet in person or online. Consent forms include HIPAA acknowledgments, consents to treat, the release of records from outside entities of the client’s choice, recipient’s rights, and acknowledgment of their involvement and receipt of a treatment plan for their provided services. Clients or guardians acknowledge they can receive services at any agency of their choice. Upon completion of consent forms, a client file is created.
All consent forms and intake paperwork are scanned or uploaded in the client’s confidential electronic file. A hard copy file will hold the originals of all paperwork obtaining original signatures of the client, and guardian, if applicable. After being scanned and uploaded into the EHR, unsigned paperwork is shredded, and hard copy files are stored in locked cabinets in locked offices, away from where clients receive services.
Clinical/Medical Team – Planning Care Meeting
After the client meets with a licensed clinician, our team of clinical professionals assesses for diagnoses and medical necessity. If services are warranted, treatment goals are also discussed and identified. The assessment, mental status exam, and intensity level are scored by scaling or CASII/LOCUS. The Clinical Director or Medical Director who completes the evaluation becomes the coordinating QMHP for the case and assigns the appropriate providers. A case manager is assigned when helpful to coordinate care and reduce unneeded treatments.
Assessment, Reassessment, & Treatment Plan Creation
Upon completion of the intake paperwork, an assessment reviews a client’s physical, functional, and psychosocial status to determine a patient’s need for care, treatment, or services. From there, a treatment plan is created for the client. The Treatment Plan includes the client’s basic, service-relative information, such as name, Insurance ID, date of birth, diagnoses, and strengths and barriers to treatment. The Treatment Plan outlines the three major dimensions that will be addressed in treatment. Under each dimension, long-term goals, short-term goals, and therapeutic interventions are outlined, along with start date, end date, and frequency of delivered care. Upon completion of the Treatment Plan, the client, guardian, if applicable, Direct Supervisor, Clinical Director, and Medical Director sign the treatment plan. Our team is here to help you sign and obtain a copy of your treatment plan right under the patient portal. When applicable and based on information received, a Prior Authorization Request is submitted to the insurance company for authorization so services can begin.
Requesting Services through Insurance Companies
When insurance companies require it, a PAR (Prior Authorization Request) is compiled and sent on your behalf. This form documents information, such as demographics, diagnoses, family history, treatment plan, and psychiatric history, and requests that your insurance company approves charges. Requests can be approved in a few hours up to 1-2 weeks. We’ll follow up on your behalf and contact you if and when the authorization comes back.
Delivery of Care, Treatment, or Services
Care, treatment, or services are provided to our clients in an interdisciplinary, collaborative manner. When services are approved, service providers are assigned to the case. Upon acceptance of the case, service providers are required to review the client’s treatment plan and sign it. Contact with the client is made in order to begin services with the client. If services are denied, the client is contacted with information regarding the denial, such as an explanation and steps for appealing the decision through a fair hearing. For approved services appointments will be scheduled and services will be rendered within the scope of practice and expertise of your health care professional.