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Mental Health Authority Services

Mental Health Authority Services. Jennifer DeCubellis, LPC, LPA Mike Taylor, LPC. Authority-Provider Split. Department of State Health Services. Other Funding Sources. Authority Services. Provider Services. Data Interface. Authority Services. Funding Oversight/Utilization Mgmt

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Mental Health Authority Services

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  1. Mental HealthAuthority Services Jennifer DeCubellis, LPC, LPA Mike Taylor, LPC

  2. Authority-Provider Split Department of State Health Services Other Funding Sources Authority Services Provider Services

  3. Data Interface

  4. Authority Services • Funding Oversight/Utilization Mgmt • Eligibility Determinations • Inpatient Authorizations • Outpatient Authorizations • Continuity of Care • Consumer Benefits Applications

  5. Authority Services (continued) • Quality Management • Network Management • Contracting • Credentialing • Claims payment

  6. Authority Services (continued) • Crisis Services • Mobile Crisis Outreach • Psychiatric Emergency Services • 23 hour Observation • Crisis Stabilization Unit • Crisis Residential Unit • Crisis Counseling Unit

  7. Authority Services (continued) • Crisis Services- Unique Needs • 24/7 services need 24/7 software • Alerts to other systems is critical to coordinate care

  8. Provider Services • Outpatient Doctor & Nurse Services • Scheduling w/ Pre-Requisite Alerts • Multiple Funding Sources = Multiple Elig., Auth., Documentation & Billing • Selective Sharing of Treatment info. • Prescription of Medications • Inpatient Services • Cont. of Care with State & Local providers. • Multi-variable census management

  9. Provider Services (continued) • Rehabilitation, Casework and Case Mgt. • “Guided” service planning and delivery • Rehabilitation Services • Caseload Management • Service Delivery Management • Billing and Collection

  10. Provider Services (continued) Pharmacy Services • Conditional Formularies • Internal & External Adjudication • PAP & Sample Management • Conditional Data Collection and Reporting • Linkage to external services

  11. Question/Answer

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