LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH
  Policy 801.08 Mental Health Plan Claim Certification
 
  PROCEDURES
  1. DMH shall submit a Mental Health Claim Certification form (MH1982 A) to the State Department of Mental Health with each submission of claims for reimbursement under the SD/MC program. Assurance of compliance shall be obtained through this mechanism.
     
    1. The Director or his/her designee shall sign the Mental Health Certification form based on attestations from managers and staff confirming that the services were performed in compliance with all applicable statutes, regulations, and/or policy requirements.
       
      1. Each employee shall certify with their name on the Daily Service Log or Group Service Log that they provided the claimed mental health services in a manner consistent with the treatment plan for each client and that, to the best of their knowledge and belief, the claims are accurate, complete, truthful, and supported by documentation recorded for those services. If the services are to be claimed to Medicare and/or SD/MC, the employee shall further certify that the services were reasonable and medically necessary.
         
      2. Program Managers shall submit a certification that services performed by their respective employees are in compliance with MHP claiming rules and regulations to the Director or his/her designee on a monthly basis by completing the MHP Claim Certification for Program Managers form. This attestation shall confirm that all claims submitted by the respective program to the Integrated System are fully compliant with this policy and applicable statutory, regulatory, or other policy requirements. 
         
    2. Upon completion of the Program Manager Certification form, the Program Manager shall forward it to his/her respective Mental Health Clinical Program Manager III for signature.
       
    3. The respective Mental Health Clinical Program Manager III shall sign the MHP Claim Certification for Program Managers form on a monthly basis to certify to the best of his/her knowledge and belief that there are processes in place for the referenced program designed to monitor and ensure compliance with SD/MC claiming requirements.
       
    4. Upon completion of the form, the Mental Health Clinical Program Manager III shall forward it to his/her respective Deputy Director for signature.
       
    5. The respective Deputy Director shall sign the MHP Claim Certification for Program Managers on a monthly basis to certify, to the best of his/her knowledge and belief that there are processes in place for the referenced program designed to monitor and ensure compliance with SD/MC claiming requirements.
       
    6. Upon completion of the form, the Deputy Director shall forward it to the DMH Director.
       
  2. DMH employees providing mental health services shall submit a completed Service Log to their Program Manager on a daily basis.
     
  3. The security of Protected Health Information (PHI) shall be maintained in compliance with applicable policies specified under Health Insurance Portability and Accountability Act (HIPAA) and as documented in the Policy Manual under Section 500.
     
    1. The Service Logs contain PHI and shall be maintained in a secure location consistent with the parameters specified in the Complete Guide to Financial Screening, Financial Services Bureau, July 2000 for Financial Record Retention and DMH Policy 508.01 or per updates of same.
       
  4. DMH programs and employees who use NCR Progress Notes and/or Medication Notes to facilitate entry of data for purposes of reimbursement shall ensure that they utilize the appropriate NCR form that contains the required attestation language.