policy

Region 10 PIHP Policies

Region 10 PIHP policies are to provide direction to support achievement of the organization's mission, vision, and values; to meet changing needs of Region 10 PIHP; to achieve compliance with applicable laws, rules, and funding requirements and; to assure responsiveness to customer/stakeholder needs.

Chapter 1: Administrative

Governance


PDF Document01.01.01 Region 10 PIHP Board  (Revised 08/2017)

PDF Document01.01.02 Board Member Per Diem and Travel Reimbursement  (Revised 08/2017)

PDF Document01.01.03 Substance Use Disorder Oversight Policy Board  (Revised 01/2016)

PDF Document01.01.04 Regulatory Compliance Committee (Issued 04/2017)   

Compliance


PDF Document01.02.01 Corporate Compliance Program  (Revised 04/2017)

PDF Document01.02.03 Conflict of Interest  (Issued 09/2013)

PDF Document01.02.04 Freedom of Information Act Requests  (Issued 10/2013)

PDF Document01.02.05 Corporate Compliance Complaint, Investigation, & Reporting Process  (Revised 04/2017)

PDF Document01.02.06 Disclosure of Information  (Revised 08/2018)

General Operations


PDF Document01.03.01 Event Notifications  (Revised 05/2016)

PDF Document01.03.02 Medicaid Provider Manual: Mental Health and Substance Abuse  (Revised 05/2016)

PDF Document01.03.03 Policy Procedure Development & Approval  (Issued 07/2016)

PDF Document01.03.04 Succession of CEO Administrative Responsibilities (Issued 03/2018)

Quality Management


PDF Document01.04.01 Quality Assessment & Performance Improvement Program  (Revised 10/2017)

PDF Document01.04.02 Input from Persons Served  (Issued 09/2013)

PDF Document01.04.03 Satisfaction Surveys  (Revised 05/2016)

PDF Document01.04.04 Behavior Management Review  (Revised 05/2016)

PDF Document01.04.05 Performance Requirements for Prevention Services (SUD)  (Issued 10/2015) 

Utilization Management


PDF Document01.05.01 Utilization Management Program  (Revised 05/2016)

Provider Network


PDF Document01.06.01 Procurement  (Revised 09/2014)

PDF Document01.06.02 PIHP Network of Service Providers  (Revised 06/2016)

PDF Document01.06.03 Contract Management  (Revised 05/2016)

PDF Document01.06.04 Delegation and Contract Monitoring  (Revised 03/2017)

PDF Document01.06.05 Credentialing and Privileging  (Revised 12/2017)

PDF Document01.06.06 Staffing Requirements for Prevention Services (SUD)  (Issued 10/2015)

PDF Document01.06.07 Reporting Requirements for Prevention Services (SUD)  (Issued 09/2015)

PDF Document01.06.08 National Outcome Measures (NOMS) - SUD  (Issued 02/2016)

Chapter 2: Human Resources

Personnel


PDF Document02.01.01 Employment  (Issued 10/2013)

Chapter 3: Information Management

Chapter 4: Fiscal Management

Budget


PDF Document04.01.01 Budgeting  (Revised 05/1206)

PDF Document04.01.02 Expense Management  (Issued 11/2013)

PDF Document04.01.03 Revenue Management  (Issued 11/2013)

Accounting


PDF Document04.02.01 Auditing  (Issued 11/2013)

PDF Document04.02.02 Fixed Assets  (Issued 11/2013)

PDF Document04.02.03 Credit Card Usage  (Issued 09/2014)

PDF Document04.02.04 Ability to Pay for SUD Services  (Revised 05/2017)

Reimbursement


PDF Document04.03.01 Denial of Claims Payment Appeal Process  (Revised 05/2016)

PDF Document04.03.02 Claims Verification  (Revised 05/2016)

PDF Document04.03.03 CMHSP Provider Advance  (Issued 12/2015)

Chapter 6: Health and Medical

Health Care


PDF Document06.02.01 Collaborative Work Between Health Care  (Issued 11/2013)

Chapter 7: Rights of Persons Served

Individual Rights


PDF Document07.01.02 Enrollee Information Rights  (Issued 02/2014)

PDF Document07.01.03 Sentinel Events Critical Incidents and Risk Events  (Revised 12/2017)

Grievances and Appeals


PDF Document07.02.01 Grievance and Appeal System (Revised 08/2018)