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PRIOR AUTHORIZATION MANUAL

PRIOR AUTHORIZATION MANUAL FY 2018 PRIOR AUTHORIZATION MANUAL REVISIONS 1 GENERAL information 2 SERVICES REQUIRING NO PRIOR AUTHORIZATION 2 GENERAL REQUEST information 3 ODMHSAS PICIS HELP DESK 4 INFORMATIONAL WEB SITE FOR PROVIDERS 4 EDUCATIONAL OPPORTUNITIES 4 SOONERCARE ELIGIBILITY 4 PROVIDER ELIGIBILITY 5 NEWLY CERTIFIED FACILITIES/INDIVIDUAL PROVIDERS 5 MEMBER NAME AND/OR SOONERCARE ID NUMBER CHANGES 5 COLLABORATION BETWEEN OUTPATIENT BEHAVIORAL HEALTH PROVIDERS 5 APPEALS PROCESS 11 PRIOR AUTHORIZATION PROCESS BEHAVIORAL HEALTH AGENCIES 12 INSTANT PRIOR AUTHORIZATION 12 Pre-Admission Services 12 OUTPATIENT REQUEST FOR PRIOR AUTHORIZATION 14 Extra Unit BH Service Plan Development Low Complexity 14 Gambling 14 OJA Multi-Systemic Therapy 15 RBMS/TFC/Therapeutic Group Homes (Levels C&E) 15 Transitional Case Management 15 Health Home 15 Mobile Crisis 16 PATH 17 Continuation of Outpatient Services (Additional 6-Month PAs) 17 PA ADJUSTMENT 19 PRIOR AUTHORIZATION PROCESS INDIVIDUAL PROVIDERS 26 INSTANT PRIOR AUTHORIZATION 26 OUTPATIENT REQUEST FOR PRIOR AUTHORIZATION 26 TYPES OF AUTHORIZATION REQUESTS 27 PA ADJUSTMENT 27 S

prior authorization manual revisions 1 general information 2 services requiring no prior authorization 2 general request information 3 odmhsas picis help desk 4

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