Forms

Provider Resources Forms

DDAP Forms


Manuals and Service Agreements


BHSI Provider Network

The BHSI Provider Network allows you to submit claim files, retrieve adjudication files and obtain approval codes for services.

BHSI has made significant changes in operating procedures. Click here to see a copy of the letter sent to providers the week of 2/22/2016. A copy of the instructions of using the new forms can be found here.

Provider Bulletins

Notices

The OAS as set deadlines for the submission of utilization and the final expense reports for agencies receiving OAS funds for support Cost Reimbursement services. The deadline information can be found here.

NEW! Department Of Behavioral Health And Intellectual Disability Services Companion Guide Trading Partner Information

NEW! BHSI Admission Auth Requirements WITS and Client Liability Form memo April 2020

NEW!
BHSI billing expectations for FY ‘2020

NEW! Telehealth expectations for the under/uninsured

Consenting to Philadelphia SCA/NIAC/BHSI inPA WITS Clarification/Additional Instruction

WITS Consent Tutorial February 2020

BHSI Treatment and OAS Cost Reimbursement FAQs

BHSI Claim Processing Go Live Date February 10, 2020

BHSI Member ID Availability

Consent to Philadelphia SCA in PA WITS Request

Claims Processing Transition Update Memo

PMHCC Change of Address

Provider Bulletin # 19-09 - BHSI Schedule of Covered Services & Rates

BHSI Billing for Fiscal Year 2019 and 2020

Secure FTP (SFTP) Request Forms -
Page 1 | Page 2

BHSI June 2019 Claims Adjudication Information Sessions

MAT Provision to BHSI Individuals Fiscal Year 2019

Authorization to Release Provider Notice

Significant Incident Report Update Provider Notice

BHSI POLICY ALERT - ICD-10 Diagnosis Code Requirements

Provider Notice 14-01
- Deadlines for claims for all services except Cost Reimbursement.

Provider Notice 16-02 - FY 17 BHSI Provider Agreements

Provider Notice 16- - Fiscal Updates

Provider Notice 15-01 - Deadlines for all Treatment and Recovery Based Services

The OAS as set deadlines for the submission of utilization and the final expense reports for agencies receiving OAS funds for support Cost Reimbursement services. The deadline information can be found here.

NEW! BHSI billing expectations for FY ‘2020

NEW! Telehealth expectations for the under/uninsured

NEW!
Consenting to Philadelphia SCA/NIAC/BHSI inPA WITS Clarification/Additional Instruction

NEW!
WITS Consent Tutorial February 2020

NEW!
BHSI Treatment and OAS Cost Reimbursement FAQs

NEW!
BHSI Claim Processing Go Live Date February 10, 2020

BHSI Member ID Availability

Consent to Philadelphia SCA in PA WITS Request

Claims Processing Transition Update Memo

PMHCC Change of Address

Provider Bulletin # 19-09 - BHSI Schedule of Covered Services & Rates

BHSI Billing for Fiscal Year 2019 and 2020

Secure FTP (SFTP) Request Forms -
Page 1 | Page 2

BHSI June 2019 Claims Adjudication Information Sessions

MAT Provision to BHSI Individuals Fiscal Year 2019

Authorization to Release Provider Notice

Significant Incident Report Update Provider Notice

BHSI POLICY ALERT - ICD-10 Diagnosis Code Requirements

Provider Notice 14-01
- Deadlines for claims for all services except Cost Reimbursement.

Provider Notice 16-02 - FY 17 BHSI Provider Agreements

Provider Notice 16- - Fiscal Updates

Provider Notice 15-01 - Deadlines for all Treatment and Recovery Based Services

The OAS as set deadlines for the submission of utilization and the final expense reports for agencies receiving OAS funds for support Cost Reimbursement services. The deadline information can be found here.

NEW! BHSI billing expectations for FY ‘2020

NEW! Telehealth expectations for the under/uninsured

NEW!
Consenting to Philadelphia SCA/NIAC/BHSI inPA WITS Clarification/Additional Instruction

NEW!
WITS Consent Tutorial February 2020

NEW!
BHSI Treatment and OAS Cost Reimbursement FAQs

NEW!
BHSI Claim Processing Go Live Date February 10, 2020

BHSI Member ID Availability

Consent to Philadelphia SCA in PA WITS Request

Claims Processing Transition Update Memo

PMHCC Change of Address

Provider Bulletin # 19-09 - BHSI Schedule of Covered Services & Rates

BHSI Billing for Fiscal Year 2019 and 2020

Secure FTP (SFTP) Request Forms -
Page 1 | Page 2

BHSI June 2019 Claims Adjudication Information Sessions

MAT Provision to BHSI Individuals Fiscal Year 2019

Authorization to Release Provider Notice

Significant Incident Report Update Provider Notice

BHSI POLICY ALERT - ICD-10 Diagnosis Code Requirements

Provider Notice 14-01
- Deadlines for claims for all services except Cost Reimbursement.

Provider Notice 16-02 - FY 17 BHSI Provider Agreements

Provider Notice 16- - Fiscal Updates

Provider Notice 15-01 - Deadlines for all Treatment and Recovery Based Services

The OAS as set deadlines for the submission of utilization and the final expense reports for agencies receiving OAS funds for support Cost Reimbursement services. The deadline information can be found here.

NEW! BHSI billing expectations for FY ‘2020

NEW! Telehealth expectations for the under/uninsured

NEW!
Consenting to Philadelphia SCA/NIAC/BHSI inPA WITS Clarification/Additional Instruction

NEW!
WITS Consent Tutorial February 2020

NEW!
BHSI Treatment and OAS Cost Reimbursement FAQs

NEW!
BHSI Claim Processing Go Live Date February 10, 2020

BHSI Member ID Availability

Consent to Philadelphia SCA in PA WITS Request

Claims Processing Transition Update Memo

PMHCC Change of Address

Provider Bulletin # 19-09 - BHSI Schedule of Covered Services & Rates

BHSI Billing for Fiscal Year 2019 and 2020

Secure FTP (SFTP) Request Forms -
Page 1 | Page 2

BHSI June 2019 Claims Adjudication Information Sessions

MAT Provision to BHSI Individuals Fiscal Year 2019

Authorization to Release Provider Notice

Significant Incident Report Update Provider Notice

BHSI POLICY ALERT - ICD-10 Diagnosis Code Requirements

Provider Notice 14-01
- Deadlines for claims for all services except Cost Reimbursement.

Provider Notice 16-02 - FY 17 BHSI Provider Agreements

Provider Notice 16- - Fiscal Updates

Provider Notice 15-01 - Deadlines for all Treatment and Recovery Based Services

Other Resources

NIATx – Removing barriers to treatment and recovery.

Selected Papers of William White - Senior research consultant Chestnut Health Systems.

N.A.R.R. - National Association of Recovery Residences.

NDCI - National Drug Court Institute.

NADCP - National Association for Drug Court Progressionals.

NIDA - National Institute on Drug Abuse.

Addiction Treatment Forum - Reports on substance abuse news of interest to opioid treatment programs.

AATOD - American Association for the Treatment of Opioid Dependence.