Source: http://www.okhca.org/providers.aspx?id=406&parts=7563_7567
Timestamp: 2018-08-16 23:44:02
Document Index: 622960613

Matched Legal Cases: ['art 1', 'art 6', 'art 21', 'art 25', 'art 26', 'art 83']

OHCA - Behavioral Health and Substance Abuse Services
Home > Providers > Types
Basic Primary and Preventive Services
A basic package of primary and preventive behavioral services, such as screenings for depression, anxiety and substance abuse is available to every SoonerCare member without prior authorization for services delivered by a Patient-Centered Medical Homes, Indian/Tribal/Urban (I/T/U) Clinics, and Federally Qualified Health Centers. Other specialty providers, (i.e., public and private outpatient behavioral health agencies, and private independent licensed practitioners) must complete preadmission forms.
Health Homes Initiative for Individuals with (Serious Mental Illness) (SMI) and Serious Emotional Disturbance (SED)
Psychiatric Consultation Program
Education and Billing
Behavioral Health Delivery in School Settings
Behavioral Health Telemedicine Services (Updated July 18, 2018)
CPT/Diagnosis Code Crosswalks
SoonerCare-Approved Behavioral Health Screening Tools and Guidelines
SoonerCare Billing and Procedure Manual
SoonerCare Provider Contracts
Behavioral Health Accrediting Organizations
Provider Certification - ODMHSAS
PRTF Survey (Cost Report)
Fee Schedules/Getting Paid
Rates and Codes for Outpatient Behavioral Health Agencies - Effective 9/1/2016
Independent LBHP Rates and Codes - effective 5/1/2016
Psychologist Rates and Codes - effective 5/1/2016
Private LBHP Rates and Codes - 9/1/2015
Private LBHP Rates and Codes - 7/1/2013
Private LBHP Rates and Codes - 1/1/2013
Psychologist Rates and Codes - 7/1/2013
Psychologist Rates and Codes - 1/1/2013
TFC Rates and Codes - 7/1/2013
Click here to access the web-based behavioral health provider directory.
Inpatient Hospital and Residential Services
Inpatient Hospital and Residential services for SoonerCare members under the age of 21 must be prior authorized before the service is provided. Telephonic initial and concurrent reviews to determine Medical Necessity Criteria (Manual) are required for the following services:
Electroconvulsive Therapy Guidelines
Psychiatric Residential Treatment Facility (PRTF) Attestations
Residential Behavior Management Services in Therapeutic Foster Care (TFC) Settings
Behavioral Health Prior Authorization Correction Request
BH Inpatient Admission Prior Authorization Template
BH Inpatient Extension Prior Authorization Template
Conditions of Treatment Participation Inpatient Psych Programs for Children
ECT Prior Authorizations
Guidance for Using the Inpatient Behavioral Health and TFC Prior Authorization Templates
Therapeutic Foster Care Notice of Admission Template v1
Therapeutic Foster Care Extension Template v3
Preadmission and Level of Care Services
Public and private outpatient behavioral health agencies, and private independent licensed practitioners must complete the Customer Data Core (CDC) Form and submit to the OHCA designated behavioral health utilization management and quality improvement organization. Currently this information must be submitted via the PI Client Information System. The information provided for pre-admission is brief and is primarily used to track the utilization of various services.
Preadmission services do not require clinical review and will be approved unless the member has exhausted the benefit or another provider has requested prior authorization for additional services.
Prior authorization is required for members who require service intensity or duration beyond the pre-admission level.
Client Assessment Record (CAR)
Customer Data Core (CDC) PA Forms (ODMHSAS site)
Prior Authorization Manual
Prior Authorization Guidelines for Psychosocial Rehabilitation Services Beginning August 1, 2014
Prior Authorization Procedure Code Groups
Prescription Medication Guidelines
Opiate Prescribing Guidelines
Reports and Evaluations, Outcomes
2013 Oklahoma Systems of Care, Successful Outcomes
2012 ECHO Child Behavioral Health Survey
2010 Behavioral Health Quality Assessment and Performance Improvement (QAPI)
2010 ECHO Child Behavioral Health (Survey)
2009 ECHO Adult Behavioral Health (Survey)
2009 Mental Health State Report Card
2009 Monthly Behavioral Health Reports (OHCA)
2009 Review of SoonerCare Behavioral Health Services – (Mathematica)
OHCA Medicaid Rules Page
Part 1 – Telemedicine
Part 6 – INPATIENT PSYCHIATRIC HOSPITALS:
Part 21 – OUTPATIENT BEHAVIORAL HEALTH SERVICES (ALL SECTIONS)
Part 25 – Psychologists
Part 26 – LICENSED BEHAVIORAL HEALTH PROVIDERS
Part 83 – RESIDENTIAL BEHAVIOR MANAGEMENT SERVICES
On the OHCA proposed rule changes page, there is a sign up button for Web Alerts.
These Web Alerts will send an email notification when there is a new posting for a proposed rule change. With each posting on this page, there is an opportunity to complete an electronic feedback form.
The OHCA seeks advice and consultation from medical professionals, professional and tribal organizations, and the general public in developing new or amended policies and rules. The proposed rule changes page is designed to give all constituents an opportunity to review and make comments regarding upcoming rule changes.
OHCA Provider Services
(800) 522-0114 and have your Provider ID number ready.
Option 6 for Prior Authorizations
Option 2 for Behavioral Health
ODMHSAS PICIS
(405) 248-9326
(855)-667-5578
NEW Web-based Directory of Behavioral Health Providers
SCC Provider Directory
Oklahoma Association of Youth Services