Blended Enhanced Case Management (Non-fidelity ACT)

The Seven Steps to a Successful Referral:

Please review the eligibility requirements for a Blended Enhanced Level of Care prior to completing the application.   
 
Please access the online BE (Non-fidelity ACT) Service Application here

1. Review Medical Necessity Criteria
2. Fill-out referral form for the CTT Program you feel is most appropriate for your participant
3. Upload all required paperwork at the end of the referral form
   * If you are unable to upload the forms please email them to the program you are referring to:  
   ‍BE (Non-fidelty ACT):  cttBEadmissions@pmhcc.org
4. CTT will review the referral and provide a conditional authorization
5. Submit a program discharge summary / letter to the program you are referring to
6. Complete closure in Webfocus
7. CTT will send out acceptance form and admission date

*** n.b CTT Case Management Programs are voluntary.  All referrals must be accompanied with a participant signature. You may download the signature form here. The signature form is used in those instances where the participant was unable to sign the original referral.