Q: What happens after I make a referral to Georgia HOPE?
A: After a referral is submitted to Georgia HOPE, our administrative team checks with the individual’s insurance provider to confirm coverage. An email is then sent to the referral source (if an email has been provided to us) to inform the referral source of whether or not the person is eligible for services. If the person is eligible for services, an Assessor then contacts the client/caregiver to set up an assessment. After the assessment, the Assessor submits a request to the payer to ask permission to begin serving the client. Each insurance provider has different approval times, but permission to begin serving is typically granted or denied within two weeks. After insurance approval is given, a therapist and/or CSS is assigned to the client and services begin.
Q: Why would someone get suspended from services?
A: There are a few reasons this might happen:
1) Client’s diagnosis has not been received: Each client being served through Core services must have a mental health or substance abuse diagnosis. The client can either meet with one of our providers to receive a diagnostic evaluation, or we can request records of a recent diagnosis from the client’s doctor. If we do not have a diagnosis within the first 30 days of treatment, we must suspend services, per Medicaid and State requirements, until the diagnosis is received.
2) Client has inactive Medicaid: We must suspend services on any client whose Medicaid becomes inactive. Inactive Medicaid status often means that paperwork needs to be submitted by the client or client’s caregiver. It is the client/caregiver’s responsibility to contact Medicaid in order to resolve the issue that led to their inactive status in the Medicaid system. The person can often learn how to resolve the issue by speaking to someone at their county DFCS office.
3) Client is in need of a Reassessment: We must suspend services when a client has not attended a reassessment appointment with Georgia HOPE. Medicaid and the State require us to conduct a Reassessment with each client every six months in order to ensure that the client still needs and wants services. If the client does not attend this appointment by the due date, they are suspended until they are able to attend.
***Please note: suspending services is not the same as closing a case. We keep the case open for a period of time in order to assist the family in resolving the issue that led to the suspension. When/if the issue is resolved, services resume.
Q: Who do I contact when I have questions about a case?
A: Your first point of contact should be the therapist or CSS who is assigned to the client. However, if you have not been able to connect with the worker, please contact your county’s Program Manager at the email or phone number listed on our Interactive Map.
Q: Why does Georgia HOPE need a signed Release of Information (ROI) to share information?
A: Because Georgia HOPE is a behavioral health provider, we are under HIPAA guidelines. These guidelines state that an adult client holds the legal right to confidentiality and, if the client is a minor, the client’s legal guardian holds the right to confidentiality. It is a client or caregiver’s legal right to refuse to sign a Release of Information (ROI) for communication with the referral source or other community partners, if they choose to do so. However, it is our agency practice to always ask the client/caregiver if they are willing to sign a ROI for the entity that made the referral.
Q: When a ROI has been signed, what kind of documentation can Georgia HOPE release?
A: So long as it is properly notated on the ROI form, we can release medical records, drug screen results and information about a client’s progress, when requested. The client should indicate what specific information (ie: drug screens, medical records, etc) they are granting permission to share. However, we cannot release therapy session notes, which are protected under HIPAA as the therapist’s personal records of session content.