Youth Home Inc TRICARE East & West Residential Program for Children Ages 12-17  with Mental Illness

New Clients

We're so happy to have you. Let's get started:

  • Fill out our Admissions / Consents form to begin the onboarding process.
  • Then call to schedule an appointment with us during our regular business hours!
Consent Form Call to Schedule an Appointment

We so look forward to meeting with you!

Welcome to BHSA

It's easy to be overwhelmed when you or someone you love is struggling with emotional or behavioral issues.


Our mission at BHSA is to equip and empower youth, adults, and families to become healthier and contributing members of the community by providing compassionate emotional and behavioral health care.


If you have any questions, please reach out to us and let us know how we can help.

What You Need to Know

  • Consents Form

    Fill out our Admissions / Consents form to begin the onboarding process:


    Then call to schedule an appointment with us during our regular business hours!


    We're so excited to work with you.

  • Initial Visit

    Please arrive at least 30 minutes before your scheduled initial assessment appointment time and 15 minutes early for all other appointments. Should you need to cancel or reschedule your appointment, please notify our front office at least 24 hours in advance. 


    A cancellation less than 24 hours before your appointment will result in a $25 fee. You may be asked to reschedule if you arrive more than 15 minutes late for your session.


  • What to Bring

    Insurance Information

    Please bring your insurance card or necessary insurance information. If your insurance carrier requires a referral, bring referral numbers and forms.


    Patient Information Form and Consents

    Before arriving to your appointment, please complete the BHSA Appointment Information and Admission Consents online. Please retain a copy of the New Client Information.  Click to view form.


    Medical Records

    Please have your medical records from previous physicians transferred to the office prior to your scheduled appointment.


    Medication List

    Please bring a list of all medications you currently are taking or have taken recently, whether over-the-counter or prescription. Include the strength and dosage of each medication.

  • Payment & Billing

    On the day of admission, clients and/or families seeking services through Behavioral Services of Arkansas should bring insurance verification cards.


    During your initial visit, staff will review your benefits, deductibles, and co-pays. Copayments are due at the time of each service unless other payment arrangements have been made. We accept payments in cash, checks, and all major credit cards. When there is no insurance, your responsibility can be determined and contracted at a rate based on your income upon request. Please note that some services may require pre-certification.


    Patients with insurance questions or concerns may contact Rachelle Harris, Billing & Credentialing Specialist at 501-954-7470, ext 218.

  • Good Faith Estimate

    Starting on January 1, 2022, the No Surprises Act1 (NSA) protects uninsured (or self-pay) individuals from many unexpectedly high medical bills.



    Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance (otherwise known as self-pay) an estimate of the bill for medical items and services. See here for our Behavioral Health Services of Arkansas - Self Pay Pricing.



    You are entitled to receive a “Good Faith Estimate” of what the charges could be for psychotherapy services provided to you. While it is not possible for a psychotherapist to know, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. This estimate is not a contract and does not obligate you to obtain any services from the provider(s) listed, nor does it include any services rendered to you that are not identified here.



    This Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to attend a specified number of psychotherapy visits. The number of visits that are appropriate in your case, and the estimated cost for those services, depends on your needs and what you agree to in consultation with your therapist. You are entitled to disagree with any recommendations made to you concerning your treatment and you may discontinue treatment at any time.



    • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.

    • Make sure your healthcare provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

    • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

    • Make sure to save a copy or picture of your Good Faith Estimate.



    For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227).

  • Medication Management

    At Behavioral Health Services of Arkansas our goal is to provide therapeutic services that include medication management. 


    Our psychiatrist are happy to manage your medication needs but they expect that you participate in the recommended treatments evaluated by the skilled clinicians in our outpatient clinic. 


    Our goal is to optimize the outcome of our services by encouraging the clients to follow the treatment recommendations from both the therapist and the psychiatrist.


    There is scientific evidence that there are different types of treatment options for different types of problems and mental health needs. Some problems are best solved by therapy services only. Then there are other treatments that the combination of therapy and medication evaluation give the best positive outcome for improvement in symptoms and mental health. 


    Our goal is to work with you to provide this combination in order to improve the overall effectiveness that both therapy and medication management can offer. We do not take medication management only clients at this time.


  • Medical Request Form

    This form is to be used by current BHSA clients only. If you have an emergency, please use a phone to dial 911.


    It is the patient’s responsibility to notify the office in a timely manner when refills are necessary.


    Approval of your refill may take up to three (3) business days, so do not wait until you have no medication remaining. You will receive notification via email once your request has been sent to the pharmacy. Please contact your pharmacy with any further questions regarding your refill status.


    Please do not make multiple requests without first waiting three business days for a response, this will only cause further delays in the refill process.


    It is important to keep your scheduled appointment to ensure that you receive timely refills. Repeated no shows or cancellations will result in a denial of refills.


    Medication refills will only be addressed during office hours (Monday - Thursday, 8 AM - 5 PM and Friday, 8 AM - 11 AM). No prescriptions will be refilled on Saturday, Sunday or Holidays.

  • Policy for Benzodiazepine Prescription

Make a Request

Medication Management

Medication Request Form

This form is to be used by current BHSA clients only. If you have an emergency, please use a phone to dial 911.


It is the patient’s responsibility to notify the office in a timely manner when refills are necessary.


Approval of your refill may take up to three (3) business days, so do not wait until you have no medication remaining. You will receive notification via email once your request has been sent to the pharmacy. Please contact your pharmacy with any further questions regarding your refill status.


Please do not make multiple requests without first waiting three business days for a response, this will only cause further delays in the refill process.


It is important to keep your scheduled appointment to ensure that you receive timely refills. Repeated no shows or cancellations will result in a denial of refills.


Medication refills will only be addressed during office hours (Monday - Thursday, 8 AM - 5 PM and Friday, 8 AM - 11 AM). No prescriptions will be refilled on Saturday, Sunday or Holidays.

Records Request

To request access to your Youth Home records, please complete the form below:

Form

Authorization To Disclose Health Information

To provide authorization for Youth Home to disclose your protected health information to another entity, please complete the form below:

Form

Authorization To Disclose to BHSA

To provide authorization for another entity to disclose your protected health information to Youth Home, please complete the form below:

Form

Consent To Email Communications

To allow e-mail communication, please complete the form below:

Form
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