What is the TRS 48 form used for?
The TRS 48 form serves as the Client Referral Form for Stutzman Addiction Treatment Center. It collects essential information about a potential client, such as their personal and health details, as well as their financial situation and insurance coverage. This information is crucial for determining eligibility and processing an admission into the treatment program.
How do I submit the TRS 48 form?
To submit the TRS 48 form, you need to fax it along with the psychosocial assessment, medical information, and any recent lab work to the Admissions Office at (716) 882-4542. Once you have sent the materials, it is important to follow up by calling (716) 882-4906 to schedule an admission date.
What information is required on the TRS 48 form?
The TRS 48 form requires various pieces of information, including the client’s personal details (like their name, address, age, and contact number), health information (current medications, health issues, and substance use history), as well as financial and insurance details (employment status, income, and health insurance coverage). This comprehensive data assists in the effective assessment and treatment planning for the client.
What should I do if the client has no health insurance?
If the client does not have health insurance, it is necessary to confirm whether an application for assistance has been initiated with the Department of Social Services (DSS). This can help the client secure necessary financial support for their treatment. Mark the “No Health Insurance” section on the form and indicate if a DSS application has been started.
What information do I need to provide regarding the client’s financial status?
When filling out the TRS 48 form, you must provide details about the client’s employment status, annual gross income, and any other sources of income, including public assistance or disability benefits. If applicable, you will need to supply documentation, such as paycheck stubs or W-2 forms, to verify the income reported.
What if the client is a registered sex offender?
The form includes a section where you can indicate whether the client is a registered sex offender. This is an important consideration in the admission process and will be taken into account when assessing the client’s needs and treatment plan.
What are the implications of having an Inpatient Rehab Rider with my insurance?
If the client has an Inpatient Rehab Rider as part of their health insurance, it is necessary to contact the insurance company to obtain a list of network providers. Should Stutzman Addiction Treatment Center be on that list, prior authorization must be secured from the insurance company before the client's admission. Failing to do so may result in financial responsibility falling to the client for the treatment costs.
Where can I find additional information about Stutzman Addiction Treatment Center?
For more in-depth information about Stutzman Addiction Treatment Center, you can refer to the Stutzman Brochure, Tips Sheet, and Weekly Schedule Sample. Additional copies of the TRS 48 form and resources can be accessed through the official website: Stutzman Admission Information.