Rating Page
5-point rating scale
|
No. of Stars |
Percentage Range | Description |
|---|---|---|
| 100% | Perfect | |
| 90% or greater | Exceeds all standards | |
| 80-89% | Meets most standards | |
| 70-79% | Nearly meets standards | |
| 60-69% | Fails to meet standards | |
| 0-Stars | Less than 60% | Performs far below standards |
NOTE: MEV State Compliance is 90% or greater.
Interactive version
| Clinic – [DATE OF REVIEW] | Score | |
|---|---|---|
| + | Clinical Chart Documentation | 3.0 |
| + | Program Specific Compliance | 4.0 |
| + | Delegated Functions Compliance | 4.5 |
| + | Medicaid Event Verification | |
| Screening, Admission, Assessment | 4.0 |
| Treatment and Recovery Planning | 2.0 |
| Progress Notes | 3.5 |
| Coordination of Care | 1.0 |
| Discharge Planning, Continuity of Care | NA |
| Residential Services | NA |
| Medication Assisted Treatment | 4.5 |
| Women's Specialty Services | NA |
| Recovery Housing | NA |
| Clinical Chart Documentation Average | 3.0 |
|---|---|
| ASAM | 2.5 |
| Residential | NA |
| Case Management | NA |
| Peer Recovery Supports | NA |
| Women's Specialty Services | NA |
| Medication Assisted Treatment | 5.0 |
| Recovery Residences | NA |
| Program Specific Average | 4.0 |
| Access and Eligibility | 5.0 |
| Information/Customer Services | 5.0 |
| Enrollee Rights and Protections | 5.0 |
| Grievances and Appeals | 4.0 |
| Individualized Treatment and Recovery Planning | 5.0 |
| Coordination of Care | 4.0 |
| Staff Credentialing | 4.0 |
| Delegated Functions Average | 4.0 |
Definitions:
- Delegated Functions –
- Programs Specific – program specific standards are based on policies and technical advisories issued by the Bureau of Substance Abuse and Addiction Services (BSAAS) or Office of Drug Control Policy (ODCP), now administered by the Behavioral Health and Developmental Disabilities Administration (BHDDA) or MSHN Contract.
- Clinical Chart Documentation –
- Medicaid Event Verification – verification of the following:
- Code is an allowable service under the contract with the payor and provider
- The consumer was eligible for Medicaid on the date of service
- The service was included in the consumers individual plan of service
- Provider documentation of the service agrees to the claim date and time of service
- Provider documentation of the service provided falls within the scope of service billed to the payor
- Amount billed does not exceed the contractually agreed amount between the payor and provider
- Modifiers are used in accordance with the HCPCS guidelines
- NA – not applicable to provider (i.e. not a service offered)