Outpatient Changes for Contracted Behavioral Health Providers
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1 Outpatient Changes for Contracted Behavioral Health Providers Prior Authorization Requirement for Mental Health Rehabilitation Services and Evidence-Based Practices BH1563_08/2018 United Behavioral Health operating under the brand Optum 2018 Optum, Inc. All Rights Reserved
2 Today s speakers Kendell Andrus Behavioral Health Network Trainer Alexandra Thorn, LCSW National Director A.L.E.R.T. Outpatient 2
3 Today s agenda What are the new requirements for Mental Health Rehabilitation (MHR) services? What services will require prior-authorization? How will UnitedHealthcare Community Plan implement these changes? 3
4 What is the new requirement? Beginning September 1, 2018 UnitedHealthcare Community Plan will require prior-authorization for MHR Services and EBPs not previously requiring authorization. 4
5 What services will require Prior-Authorization? 5
6 The LA Page of Provider Express Prior Authorization Request Form 6
7 Provider Express All MHR services are now being prior authorized through a portal located on the Provider Express website To access the request form link go to: providerexpress.com > Our Network > Welcome to the Network > Louisiana > Authorization Templates 7
8 The Louisiana Page on Provider Express 8
9 Health LA MHR and EBP Request Form 9
10 UnitedHealthcare Provider Website UHCprovider.com LINK Prior Authorization and Notification Tool 10
11 Accessing your prior authorizations online UHCprovider.com Link Log-In 11
12 LINK Dashboard 12
13 Accessing your prior authorizations 13
14 Accessing your prior authorizations cont. 14
15 Accessing your prior authorizations cont. 15
16 Accessing your prior authorizations cont. 16
17 Accessing your prior authorizations cont. 17
18 Prior Authorization and Notification Tool Resources Live training session UHCprovider.com > Menu > Resource Library > Training > Prior Authorization and Notification Overview UHC On Air UHCprovider.com > Menu > Resource Library > UHC On Air Other training resources UHCprovider.com > Menu > Prior Authorization and Notification > Prior Authorization and Notification Tool > Quick Reference Guides, Videos and Training Tools 18
19 Frequently Asked Questions Where do I submit my authorization requests? The Louisiana Page of Provider Express To access the request form link go to: providerexpress.com > Our Network > Welcome to the Network > Louisiana > Authorization Templates 19
20 Frequently Asked Questions cont. Where do I check online for my authorizations? Via LINK on UHCprovider.com To access the Prior Authorization and Notification Tool Go to: UHCprovider.com >LINK > Sign In: With Your Optum ID and Password > Prior Authorization and Notification Tool Prior Authorization and Notification 20
21 Frequently Asked Questions cont. If I am having trouble viewing my authorization online, who do I contact? Technical Assistance 21
22 Frequently Asked Questions cont. What if I have not received my administrative authorizations? Send a list of the members to networkse@optum.com Information to include: Member Name/ID Date of Birth What Services or Needed 22
23 Frequently Asked Questions cont. Is the submission process the same for Homebuilders, Functional Family Therapy, and Multi-Systemic Therapy? The LOCUS/CALOCUS and the Members Choice Form are not required Assessments are not required with the initial request (Please submit assessment with the follow-up requests.) Please request the authorization within hours of initial assessment 23
24 New members requiring MHR services For new enrollees seeking MHR services after September 1, 2018, providers will need to obtain prior authorization from UnitedHealthcare Community plan using the new portal The following information will be needed for all new and subsequent authorization requests for CPST and PSR services: Level of Care Utilization System (L.O.C.U.S). Assessment Children and Adolescent Level of Care Utilization System (C.A.L.O.C.U.S.) Assessment Member Choice Form 24
25 Need more units for new or existing members? To request more units for new or existing members: Go to: providerexpress.com > Our Network > Welcome to the Network > Louisiana > Authorization Templates Complete the Healthy Louisiana Mental Health Rehabilitation and Evidence Based Practices Request Form Include the LOCUS and/or CALOCUS Assessment Member Choice Form Providers can request more units through the portal before the end of the six month period. 25
26 Level of Functional Impairment Reminder 26
27 UnitedHealthcare Community Plan Provider Call Center or 27
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