Division of Behavioral Health Services
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BHS Definitions List (revised 10/01/14)
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Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services
EPSDT covered services correct or ameliorate physical and mental defects, conditions, and illnesses discovered by the screening process when those services fall within one of the 28 optional and mandatory categories of "Medical Assistance" as defined in the Medicaid Act (Federal Law Subsection 42 USC 1396d (a)).
Services covered under EPSDT include all 28 categories of services in the Federal Law even when they are not listed as covered services in the AHCCCS State Plan, AHCCCS statutes, rules, or policies as long as the services are medically necessary and cost effective.
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Periodicity Schedule
A comprehensive periodic screenings that must be performed by a clinician based on the time frames identified by AHCCCS and the Arizona Medical Association and is closely aligned with guidelines of the American Academy of Pediatrics.
Identification of individuals with suspected behavioral health problems for the purpose of addressing the problems before they get worse. It may involve referring individuals for assessment and treatment for example, and routine evaluations done by health care providers.
A check to ensure that data in a field is valid and complete.
Emergency Behavioral Health Services
Covered inpatient and outpatient services provided after the sudden onset of an emergency behavioral health condition. These services must be furnished by a qualified provider, and must be necessary to evaluate or stabilize the emergency behavioral health condition.
Emergency Safety Situation
Unanticipated resident behavior that places the resident or others at serious threat of violence or injury if no intervention occurs and that calls for the use of restraint or seclusion as an immediate response. (42 CFR 483.352)
Emerging Family Leaders
A diverse cadre of family leaders who have been actively involved in the planning of their own children's care and is interested in making a positive impact in the quality of services and supports delivered to all children and families in their community. These emerging leaders are supported, coached and mentored, and trained by family members who are further in their journey. For diversely identified communities, the term "Emerging Family Spokesperson" may be more appropriate than Emerging Family Leader. Explore the appropriateness of terminology and definition with the individual and the community.
A pattern of ridiculing or demeaning a vulnerable adult, making derogatory remarks to a vulnerable adult, verbally harassing a vulnerable adult or threatening to inflict physical or emotional harm on a vulnerable adult.
An intentional, dynamic, ongoing process involving mutual respect, critical reflection, caring and group participation, through which people lacking an equal share of valued resources gain greater access to and control over those resources.
A record of a covered service rendered by a provider to a person enrolled with a capitated RBHA on the date of service.
The establishment of a trusting relationship, rapport and therapeutic alliance based on personal attributes, including empathy, respect, genuineness and warmth.
A Title XIX/XXI or Non-Title XIX/XXI eligible person recorded in the ADHS/DBHS Information System as specified by ADHS/DBHS.
The process by which a person is enrolled into the Contractor and ADHS/DBHS data system.
Episode of Care
The period between the beginning of treatment and the ending of behavioral health services for an individual. Within an episode of care, a person may transfer to a different service, facility, program or location. The beginning and end of an episode of care is marked with a demographic file submission. Over time, an individual may have multiple Episodes of Care.
Programs or practices which have several of the characteristics listed below: replication, sustained effects, published in a peer reviewed journal, a control group study, cost benefit analysis, adequately prepared and trained staff, appropriate supervision, include assessment and quality assurance processes, consumer and family involvement, cultural, gender, and age appropriateness, and coordination of care.
Evidence Based Practice
Practices, based on research findings and expert or consensus opinion in regard to available evidence, that are expected to produce a specific clinical outcome.
Experimental or investigational therapies
Treatments which are not generally considered standard of care within the psychiatric medical community. In addition, these therapies are not usually considered a covered benefit by the state and federal statute.
Explanation of Benefits
Forms that are sent by payors to both enrollees and providers. Explanation of Benefits (EOBs) provide necessary information about claim payment information and patient responsibility amounts. Patient responsibility amounts are needed for accurate patient balance billing.
The illegal use of a client's resources for another individual's profit or advantage according to A.R.S. Title 46, Chapter 4 or Title 13, Chapter 18, 19, 20, or 21.
Exploitation (of incapacitated or vulnerable adult)
The illegal or improper use of an incapacitated or vulnerable adult or his/her resources for another's profit or advantage.