Module 03 Revenue Protection & CCR Mastery

Stop the Revenue Leak.
Master Every Deadline.

Prior Authorizations are where BHRFs lose money fastest. BHRFManager replaces spreadsheet errors and missed CCR deadlines with automated math and guided submissions for every AHCCCS health plan.

The Reality of "Retro-Active" Care

"AHCCCS does not retroactively cover the gap. Every day you wait to submit is a day of care you provide for free."

Critical CCR Monitor

!

Red: Expires in 48 Hours

Member: T. Williams (Mercy Care)

Last 3 Psych Notes Required*

CCR

Orange: Due in 5 Days

Member: K. Davis (Tribal FFS)

Plan Requirement: 14-Day Window

LIVE DEADLINE SYNC: ACTIVE
Escalated Alert

"Sent to Owner & PM: 1 Urgent Admission at 72hr mark."

The Math That Breaks Spreadsheets,
Done For You.

Different health plans operate on different clocks. One spreadsheet error or a single staff change, and a CCR slips—turning authorized care into unbillable revenue loss. BHRFManager calculates every deadline automatically based on the specific member plan.

5d

Mercy Care / ACC-RBHA

Concurrent Review Window

14d

AHCCCS FFS / Tribal RBHA

Concurrent Review Window

"The plan-specific math that breaks every spreadsheet is done for you, automatically, every single time."

Live CCR Calculator

Sync Date: April 28, 2026

Auto-Calculate On
Member: Jessica R. ID: A64281

Health Plan

Mercy Care

LCD Date

May 15, 2026

CCR Submission Due

May 10, 2026

BHRFManager: 5-Day Rule Applied Automatically

DFSM Training Standard (Rev. 2026)

01

Verify Eligibility

Real-time AHCCCS portal verification.

02

Confirm PA Necessity

Automated check for existing auths.

03

Submit via Correct Portal

Pre-filled: B8 | BP | H | H0018

04

Document Upload

Exact Codes, Pre-Loaded.
Zero Submission Errors.

Every BHRF authorization requires the exact combination of Provider Type, Event Type, Activity, and HCPCS. One typo means an instant denial. BHRFManager pre-fills every AHCCCS code combination automatically, making submission errors statistically impossible.

H0018 Enforcement

The system locks HCPCS codes to BHRF-specific standards.

Portal Guidance

Direct links to the correct portal for each health plan.

Proactive Monitoring

The Email That Finds You
Wherever You Are.

The BHRFManager Alert System doesn't just light up a dashboard. It sends a critical escalation email directly to the Owner and Program Manager. Whether you're in the office or at your daughter's soccer game, you’ll know exactly when an authorization is at risk.

Green: 14+ Days Remaining — All Clear.

Orange: CCR Due within 7-14 Days — Plan Ahead.

Red: Expires within 7 Days — Action Required Today.

BM
BHRFManager Alert
Just Now

CCR Submission Overdue

Member: T. Williams
Plan: Mercy Care
LCD: May 02

OPEN SUBMISSION PORTAL

"The email contains the member name, AHCCCS ID, and a direct link to the right submission portal."

PA Packet Requirements

Health Plan: Mercy Care ACC-RBHA

BH Assessment (BHP Signed) PASS
Tx Plan (Signed < 30 Days) PASS
Last 3 Psych Notes (Required) MISSING
Discharge Plan PENDING

Mercy Care Additional Fields

BHRF Type: ABHTH
Guardian Signed: Yes

Guided Completion.
First-Time Approvals.

Each health plan has its own "brutal" requirements. BHRFManager presents a visual pass-fail grid for every document required. No PA gets submitted incomplete. No team member has to memorize which plan needs what.

Mercy Care Specific Logic

Automatically unlocks fields for behavioral changes, member location, and the specific BHRF type required for SMI admissions.

Enforced Completeness

The system prevents submission until every pass-fail document—including the treatment plan (not older than 30 days)—is confirmed on file.

High-Velocity Revenue Protection

Protect Those
5 Critical Days.

When a member is admitted urgently, AHCCCS DFSM only authorizes the initial 5 days. Without immediate full-PA submission, day 6 onward is unbillable. BHRFManager tracks every urgent admission from minute one—counting down the window and alerting you at the 48-hour and 24-hour marks.

Minute-One Tracking

The system locks in the admission timestamp and begins the countdown for the full PA submission immediately.

Escalated Alerts

Automatic notifications trigger at 48 and 24 hours to ensure your team finishes the packet before the window closes.

Urgent Admission Clock

48 Hours
:
59 Mins
MEMBER #9921 ACTION REQ

Full PA Submission Pending

Day 1-5: Covered

Status: Currently Billable

"Preventing the silent revenue bleed that catches most facilities by surprise."

Every Authorization. Every Deadline.
One Single Screen.

Whether you have 5 members or 50, your entire authorization landscape is visible in real-time. No more calling clinical staff for psych notes or billing for claim status.

All Auths
Pending
Expiring (3)
Member Health Plan Status CCR Deadline Action

T. Williams

ID: A64281

Mercy Care Expiring

May 01 (3 Days)

M. Johnson

ID: B11920

Tribal RBHA Urgent Admin

48hr Window

K. Davis

ID: C88273

AZ Complete Approved

18 Days Left

Recently Denied? Reason codes are pulled for instant resubmission.

Sort by Urgency to prioritize today's workload.

Filter by Health Plan to batch submissions.

Precision Record-Keeping

Your History is Your
Financial Defense.

Every initial PA, every concurrent review, and every denial reason is permanently archived per member. When billing asks why a claim was rejected, or a health plan auditor reviews your patterns—you have total proof. The audit-defensible record builds itself.

Permanent Vault

Archived forever. Even if a staff member leaves, the authorization history stays accessible and organized.

Denial Traceability

Track resubmissions and reason codes to identify which health plans are flagging specific documentation patterns.

JD

John Doe (AHCCCS #44821)

History Archive

Concurrent Review Approved

April 15, 2026 • Ref: 8829441

Auth Resubmitted

April 12, 2026 • Updated: Psych Notes

!

Initial Denial: Reason Code 12

Missing Signature on Treatment Plan

"Stop the audit in its tracks with a complete digital history of every dollar authorized."

From Anxious Guessing
to Predictable Cash Flow.

You stop submitting claims hoping they get paid—you start submitting knowing exactly what is covered. BHRFManager turns Authorization Mastery into your facility's greatest competitive advantage.

The Old Way: 12 Hours / Week

  • "Is M. Johnson’s CCR due in 5 days or 14 days?"
  • "Why was K. Davis denied? What document was missing?"
  • Providing care for free during "auth gaps."

The BHRFManager Way: 90 Mins / Week

  • Exact codes, portals, and checklists pre-loaded.
  • Health-plan math done automatically, every time.
  • Every dollar of authorized care is captured and paid.

Total Revenue Protection. Zero Deadline Anxiety.

Stop losing days of revenue to administrative complexity. Deploy Module 03 and turn your highest-risk financial process into a precision exercise.

Mercy Care ACC AZ Complete Health AHCCCS FFS/Tribal

"This is what makes business ownership fun again—when the deadlines take care of themselves."