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The purpose of this memo is to notify providers that the Residential Treatment Services Manual has been updated with the following changes:

• Definitions have been moved from Chapter 2 and Chapter 4 to a newly created Definitions Appendix (Appendix A.)

• Provider enrollment language in Chapter 2 was updated to reflect current practice. Language in this chapter was also reorganized for clarity.

• Language in Chapter 4 was updated to reflect changes in the processing of behavioral health fee-for-service (FFS) service authorizations.  References to CMHRS services were also updated in this chapter to reflect current Mental Health Services.

• The Independent Assessment Certification and Coordination Team (IAACT) Appendix was updated to reflect changes in the processing of behavioral health FFS service authorizations. The IAACT Appendix was also reorganized for clarity and to reflect current practice. 

• Billing guidance has been updated in Chapter V.

To avoid disruption to claims payment through FFS and the MCOs providers must periodically check the DMAS provider portal, also known as the Provider Services Solution (PRSS), to ensure that the provider's enrollment, contact information, and license information is up to date, for all of the provider's respective service locations. Under federal rules, MCOs and DMAS are prohibited from paying claims to network providers who are not enrolled in PRSS. Additional information is provided on the MCO Provider Network Resources webpage and includes links to resources, tutorials and contact information to reach Gainwell with any provider enrollment or revalidation related questions.  Dental providers should continue to enroll directly through the DMAS Dental Benefits Administrator, DentaQuest.