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INCEDO PROVIDER PORTAL QUICK REFERENCE GUIDE

TM INCEDO PROVIDER PORTAL QUICK REFERENCE GUIDE BH2563_12/2019 United Behavioral Health operating under the brand Optum1 BH2563_12/2019 United Behavioral Health operating under the brand Optum Contents Logging in to INCEDO PROVIDER PORTAL ..2 Navigating the Dashboard ..3 Menu Bar Items ..3 Home ..3 About Navigation tips: ..4 Membership ..4 Adding an Uninsured Member ..5 Authorizations ..9 Requesting an Step 1: Service Request ..9 Step 2: Define Service Step 3: Update Step 4: Request Authorization Status ..14 Concurrent review ..15 Claims Management ..15 Claim Status ..17 Filtering BH2563_12/2019 United Behavioral Health operating under the brand Optum Logging in to INCEDO PROVIDER PORTAL The purpose of this GUIDE is to describe the use and functionality of the INCEDO PROVIDER PORTAL .

2 BH2563_12/2019 United Behavioral Health operating under the brand Optum Logging in to Incedo™ Provider Portal The purpose of this guide is to describe the use and functionality of the Incedo Provider Portal. Incedo Provider Portal is used verify eligibility, enter requests for authorizations and to submit claims.

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Transcription of INCEDO PROVIDER PORTAL QUICK REFERENCE GUIDE

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PROVIDER ALERT

maryland.optum.com

policies, procedures, transmittals, and guidelines issued by the Department, including but not limited to, verifying Recipient eligibility, obtaining prior authorizations submitting accurate, complete and timely claims, and conducting business in such a way the

  Guidelines, Obtaining

Psychiatric Rehabilitation Program (PRP) - Minor

maryland.optum.com

program o Must explicitly state PRP (Psychiatric Rehabilitation Program) • Individualized Rehabilitation Plan (IRP) which indicates the participant and/or guardian participated in the planning and agrees with the plan. • DLA-20 completed within Incedo Provider Portal o For TAY Participants only

  Programs, States, Planning

PSYCHIATRIC REHABILITATION PROGRAMS (PRP) …

maryland.optum.com

memo on April 25, 2012. As an alternative to referral, documented evidence of clinical collaboration between the treating therapist and rehabilitation staff is permitted for concurrent authorizations, as discussed in the provider alert titled “Psychiatric Rehabilitation Program Referrals (PRP-A/PRP-M)

  Rehabilitation, Referral

Psychiatric Rehabilitation Program (PRP) - Adult

maryland.optum.com

Eligibility and Funding ... • The individual continues to meet admission criteria • There is clinical evidence justifying ongoing services • Signed and dated IRP with specific information about participant’s ... **RN-C, CAC-AD, and CSC-AD are not eligible to make referrals

  Eligibility, Clinical, Criteria, Eligible, Funding

State of Maryland Medical Necessity Criteria

maryland.optum.com

State of Maryland Medical Necessity Criteria Document Number: BH803MDSCC012020 Effective Date: July 1, ... There is clinical evidence that disposition planning, progressive increases in hospital privileges, ... • There must be a reasonable expectation by the family and treating clinician that if treatment services as

  States, Medical, Family, Clinical, Planning, Maryland, Criteria, Necessity, State of maryland medical necessity criteria

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