Referral Policy

Horizon Ridge Clinic’s goal is to assist child, adolescence, adults and families with a moderate to severe or enduring mental health condition to regain their confidence and skills in order to get back to self-sufficiency, employment, family reunification, life stability, choices, advocacy, and pursue of educational goal.

  1. We are a mental health, drug, and alcohol rehabilitation center that support individuals with mental health problems who wish to improve their confidence, self-sufficiency, skills etc., with a view to returning to a mainstream environment.
  2. We are not a day center, daycare or a drop in or a hobby place, referrals should not be made, and places will not be offered, to individual wishing just to fill their time.
  3. We can accept referrals from approved secondary mental health services, client based referral, case managers, state/county/city social service referrals and other acceptable service providers.
  4. If our client is a minor child, in order for our agency to provide services to that minor child the parents/guardian and all members of the household, to include, siblings will have to fully participate in the service plan for that individual.
  5. All clients will have to agree to participate in case planning meetings that will typically be held on site that will be determined based on the treatment goals.
  6. New referrals will only be added to the waiting list once we have all the documentation. Referrals without this documentation will be held pending receipt of the correct paper work for a maximum of two months. If the paper work is not received by this point the referral will be closed.
  7. All referrals should have a primary diagnosis of a mental health issue that warrants service interventions.  Referrals for individuals with dual diagnosis, for example, mental health and learning disabilities, mental health and ASD and mental health and physical impairments will only be considered if the mental health element is the primary issue. It is not appropriate to offer dual diagnosis clients a place if mental health is the secondary concern. Every case will be assessed and decided individually based on our perception of the effectiveness of possible interventions and in line with our commissioning guidelines.
  8. We reserve the right to decline services to individuals with ongoing substance misuse issues, repeated service non-compliance or those with a history of violence or aggression towards themselves and others.
  9. We have a zero tolerance policy towards any form of aggression, physical or verbal.  Clients who exhibit such behaviors may be asked to leave.
  10. Clients with severe complex needs will only be offered places where there is continuing involvement with other services working in a multidisciplinary approach.  Such clients may have to wait longer for the service dependent upon our current client profile.

The client, upon completion of the intake assessment, when applicable, will be referred for an initial mental health assessment performed by a licensed professional and/or an approved mental health professional. The initial mental health assessment will be scheduled through the Care Coordinator. The intake packet itself will be provided to the licensed professional and/or an approved mental health professional by the Care Coordinator staff within two (2) business days; prior to the client’s initial appointment with the licensed professional and/or an approved mental health professional. A signed Authorization to Release Information form will be completed with the assistance of the client, guardian, and/or court appointed custodian prior to releasing confidential information along with all pertinent documentation.

Eligibility Determination

Individuals, guardians, and court appointed custodians may apply for services provided by Horizon Ridge Clinic. We are a Type 14 Provider for Medicaid. We accept Fee-for-Service (STRAIGHT) Medicaid, and cash clients using a sliding fee scale. Eligibility for specific services will be determined based on the client’s insurance eligibility or a sliding scale fee ability to pay. As long as the following requested services meet the required guidelines: the client’s diagnostic group fall under the Diagnostic and Statistical Manual of Mental Disorder (a.k.a. DSM IV); the level of services meets the least restrictive criteria; and insurance carrier funding is available or demonstrate the ability to cash pay. In most cases, the client will be eligible to receive the team’s recommended services. An intake packet will be completed at the start of the initial process to determine eligibility for services. An Intake Mental Health Assessment will be often completed at the time of intake as part of the data collection. The intake assessment will be conducted within five (5) business days of receipt of insurance eligibility. In the case that the initial service authorization is not completed with the notice, it will be determined within five (5) more working days. All service request are approved at the discretion of the insurance carrier. Services are not rendered prior to receipt of approval from insurance carrier. The insurance carrier at times will deny services based on medical necessity. We will submit request for revisions and peer-to-peer consultations in most cases for reconsideration of recommended services, however, approvals will be determined by the insurance carrier.