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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 22. HEALTH |
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SubTilte 22-A. MENTAL HEALTH |
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Chapter 22-A25. HEALTH HOME CERTIFICATION STANDARDS |
Section 22-A2516. HEALTH HOME RECORDS AND DOCUMENTATION REQUIREMENTS
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2516.1Each Health Home shall utilize the Department’s electronic record system, iCAMS, for documenting and billing all Health Home services.
2516.2Health Home providers shall maintain all Health Home consumer information in accordance with federal and District privacy laws and the Department’s Privacy Manual.
2516.3Health Home providers shall document each Health Home service and activity in the consumer’s iCAMS record. Any claim for services shall be supported by written documentation which clearly identifies the following:
(a) The specific service type rendered;
(b) The date, duration, and actual time, a.m. or p.m. (beginning and ending), during which the services were rendered;
(c) Name, title, and credentials of the person who provided the services;
(d) The setting in which the services were rendered;
(e) Confirmation that the services delivered are contained in the consumer’s CCP;
(f) Identification of any further actions required for the consumer’s well-being raised as a result of the service provided;
(g) A description of each encounter or service by the Health Home team member which is sufficient to document that the service was provided in accordance with this chapter; and
(h) Dated and authenticated entries, with their authors identified, which are legible and concise, including the printed name and the signature of the person rendering the service, diagnosis and clinical impression recorded in the terminology of the International Statistical Classification of Diseases and Related Health Problems – 9 (ICD-9 CM) or subsequent revisions, and the service provided.
2516.4No Health Home provider shall be reimbursed for a claim for services that does not meet the requirements of this section or is not documented in accordance with this section.
2516.5Health Home providers shall implement a compliance program that regularly reviews submitted claims and identifies errors and overpayments. Health Home providers shall repay any paid claims that do not meet reimbursement criteria within sixty (60) days of discovery.