Pre-Admission Reviews (PAR)
One of the primary responsibilities of COPE is to, on behalf of the DWMHA, conduct Pre-Admission Reviews(s). The purpose of the PAR is to determine, based on eligibility and clinical presentation, the level of care in which the DWMHA will accept payment responsibility.
Determination of payment responsibility does not constitute denial of service and the requestor may choose to place the consumer at a higher level of care than is initially authorized, appeal payment in the future or request a second opinion and appeal the decision at the time of the PAR.
A COPE psychiatrist is available 24-7 to discuss level of care determinations with the requester's medical staff.
PARs are conducted both telephonically and face-to-face. A telephonic review is conducted when one or more of the following critical indicators are present, in the absence of substance intoxication, that are indicative of intense severity of symptoms and clear need for the intensity of inpatient services.
Serious suicide attempt
Harm committed to someone else
Damage committed to property
Severe psychosis with refusal of medication
The accuracy, consistency and expediency of the PAR are each critical. Inter-rater reliability measures are conducted regularly to ensure consistency.
Expediency is measured by the time it takes for:
Calls to be received (less than 20-seconds)
Services to begin (less than 15- minutes)
Dispositions to be determined (less than 3-hours).
Staff of emergency departments and Adult Foster Care homes may request a Pre-Admission Review.