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Referrals

- Services
TO REFER TO STRATEGIC INTERVENTIONS LLC
(OPTIONAL SHORT FORM)
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- Please complete the form below then hit SUBMIT when done. We will follow up with you shortly.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
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- Preferred Treatment Location
  
  Select your preference Greensboro Burlington Marion Statesville Morganton Warrenton
- GENERAL INFORMATION ON YOUR REFERRAL (age, gender, conditions, etc)
- Other Comments
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Criteria for ACTT services:
(CLICK HERE to view the ACTT Service Definition Criteria link).

Should you like to obtain more information about the service or determine if it is the appropriate level of care after reviewing the criteria for ACTT services, feel free to contact one of our offices or submit your basic information for a referral using the short referral form on the left side of this page. We will then get back in touch with you for more detailed information.

To make a referral via telephone please call 828-655-3113.

The process after the referral has been made:
1. A member of our team will reach out to you within 7 days to conduct a brief screening and/or schedule and intake/assessment appointment.

2. Once the intake documents and a clinical comprehensive assessment have been completed and there is evidence of medical necessity, a service authorization request will be submitted to the local Managed Care Organization (MCO) for approval. Should the referral NOT meet entrance criteria and/or medical necessity for ACTT services, the individual and/or agency who submitted the referral will be made aware and offered options for a more appropriate level of care.

3. While awaiting the approval of the authorization request (2-14 days), ACTT staff will continue to monitor the individual, begin assertive engagement and start the treatment planning process. Should the authorization request be denied, a member of our team will offer assistance with the appeal process and/or make a referral to a lower level of care as indicated by the local MCO.

Should you wish to submit a more detailed referral form and more complete information, CLICK HERE to open our Interactive Referral Form

After opening our Interactive Referral Form, save it to your computer, then re-open it, complete it by typing in information or checking appropriate boxes, then resave it before emailing it to us.

You can send the referral form to us by clicking on the SUBMIT button below, then attaching your completed form to the email that opens.