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Value Behavioral Health of Pennsylvania - A ValueOptions Company
 
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 Provider Manual
NOTIFICATION OF CHANGE IN ACCESS TO SERVICES
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Providers must also immediately notify the VBH-PA Service Center either in writing, to the attention of the Network Management Department, or by facsimile to 724-744-6363, upon the occurrence of any of the following:

  1. Inability to provide emergent care within 1 hour, urgent care within 24 hours or routine care within 7 days;

  2. Usage of alternative provider coverage in any situation when unable to treat VBH-PA members in active treatment (e.g. vacation);

  3. When reaching full (100%) capacity.  Full capacity is considered the point at which the provider is unable to meet the access standards noted above or is unable to accept referrals for a particular level of care.  Notices for full (100%) capacity should contain the reason for reaching capacity, the effective date, and the steps the provider will take to resume functioning at normal capacity.

Network providers must offer hours of operation that are no less that the hours of operation offered to commercial members or comparable to Medicaid fee-for-service if the provider serves only Medicaid members.

 

 
 
 
 
   
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