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This document is an addendum for hospitals undergoing ownership changes that seek participation in BCBSM's Mental Health and Substance Abuse Managed Care networks for inpatient psychiatric care.

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How to fill out ADDENDUM TO HOSPITAL TRADITIONAL/TRUST APPLICATION FOR PARTICIPATION IN BCBSM'S MENTAL HEALTH AND SUBSTANCE ABUSE MANAGED CARE NETWORKS FOR INPATIENT PSYCHIATRIC CARE

1. Obtain the ADDENDUM form from the BCBSM website or the responsible department.
2. Review the instructions carefully for any specific requirements or information needed.
3. Fill out the hospital's information in the designated sections including name, address, and contact details.
4. Provide details about the psychiatric services offered by the hospital, specifying any special programs or certifications.
5. Include the names and qualifications of key personnel involved in the delivery of mental health and substance abuse services.
6. Attach any necessary documentation that supports the application, such as licenses and accreditation certificates.
7. Complete any required financial information, ensuring accuracy and compliance with BCBSM's guidelines.
8. Review the completed form for any errors or omissions before submission.
9. Submit the ADDENDUM to the designated BCBSM address or through the specified submission method.
10. Keep a copy of the submitted form and any correspondence for your records.

Who needs ADDENDUM TO HOSPITAL TRADITIONAL/TRUST APPLICATION FOR PARTICIPATION IN BCBSM'S MENTAL HEALTH AND SUBSTANCE ABUSE MANAGED CARE NETWORKS FOR INPATIENT PSYCHIATRIC CARE?

1. Hospitals seeking to participate in BCBSM's Mental Health and Substance Abuse Managed Care Networks for inpatient psychiatric care.
2. Healthcare providers aiming to offer accredited mental health and substance abuse services under BCBSM's guidelines.
3. Facilities wanting to ensure reimbursement for psychiatric services through BCBSM.

For pdfFiller’s FAQs

What is ADDENDUM TO HOSPITAL TRADITIONAL/TRUST APPLICATION FOR PARTICIPATION IN BCBSM'S MENTAL HEALTH AND SUBSTANCE ABUSE MANAGED CARE NETWORKS FOR INPATIENT PSYCHIATRIC CARE?

The ADDENDUM TO HOSPITAL TRADITIONAL/TRUST APPLICATION is a document required for hospitals seeking participation in Blue Cross Blue Shield of Michigan's (BCBSM) Mental Health and Substance Abuse Managed Care Networks specifically for inpatient psychiatric care. It provides necessary details regarding the hospital's capabilities and compliance with the network's requirements.

Who is required to file ADDENDUM TO HOSPITAL TRADITIONAL/TRUST APPLICATION FOR PARTICIPATION IN BCBSM'S MENTAL HEALTH AND SUBSTANCE ABUSE MANAGED CARE NETWORKS FOR INPATIENT PSYCHIATRIC CARE?

Hospitals that wish to participate in BCBSM's Mental Health and Substance Abuse Managed Care Networks for inpatient psychiatric care are required to file this addendum. This includes both new applicants and existing providers seeking to maintain or expand their participation.

How to fill out ADDENDUM TO HOSPITAL TRADITIONAL/TRUST APPLICATION FOR PARTICIPATION IN BCBSM'S MENTAL HEALTH AND SUBSTANCE ABUSE MANAGED CARE NETWORKS FOR INPATIENT PSYCHIATRIC CARE?

To fill out the addendum, hospitals must gather relevant data concerning their services, staff credentials, and operational policies. Each section of the application must be completed accurately, ensuring all required documentation is attached, including any specific details about their mental health and substance abuse services.

What is the purpose of ADDENDUM TO HOSPITAL TRADITIONAL/TRUST APPLICATION FOR PARTICIPATION IN BCBSM'S MENTAL HEALTH AND SUBSTANCE ABUSE MANAGED CARE NETWORKS FOR INPATIENT PSYCHIATRIC CARE?

The purpose of the addendum is to ensure that BCBSM can assess the hospital's qualifications and compliance with the standards required for participation in their managed care networks. It helps BCBSM to maintain a network of facilities that provide high-quality mental health and substance abuse services.

What information must be reported on ADDENDUM TO HOSPITAL TRADITIONAL/TRUST APPLICATION FOR PARTICIPATION IN BCBSM'S MENTAL HEALTH AND SUBSTANCE ABUSE MANAGED CARE NETWORKS FOR INPATIENT PSYCHIATRIC CARE?

The addendum requires information such as hospital identification details, types of mental health and substance abuse services offered, licensing and accreditation details, staffing qualifications, treatment protocols, and any relevant clinical data that demonstrates the hospital's capacity to provide inpatient psychiatric care.