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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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Presentation Transcript
mental health authority services

Mental HealthAuthority Services

Jennifer DeCubellis, LPC, LPA

Mike Taylor, LPC

authority provider split
Authority-Provider Split

Department of State Health Services

Other Funding Sources

Authority Services

Provider Services

authority services
Authority Services
  • Funding Oversight/Utilization Mgmt
  • Eligibility Determinations
  • Inpatient Authorizations
  • Outpatient Authorizations
  • Continuity of Care
  • Consumer Benefits Applications
authority services continued
Authority Services (continued)
  • Quality Management
  • Network Management
    • Contracting
    • Credentialing
    • Claims payment
authority services continued7
Authority Services (continued)
  • Crisis Services
    • Mobile Crisis Outreach
    • Psychiatric Emergency Services
    • 23 hour Observation
    • Crisis Stabilization Unit
    • Crisis Residential Unit
    • Crisis Counseling Unit
authority services continued8
Authority Services (continued)
  • Crisis Services- Unique Needs
    • 24/7 services need 24/7 software
    • Alerts to other systems is critical to coordinate care
provider services
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
provider services continued
Provider Services (continued)
  • Rehabilitation, Casework and Case Mgt.
    • “Guided” service planning and delivery
    • Rehabilitation Services
    • Caseload Management
    • Service Delivery Management
    • Billing and Collection
provider services continued11
Provider Services (continued)

Pharmacy Services

  • Conditional Formularies
  • Internal & External Adjudication
  • PAP & Sample Management
  • Conditional Data Collection and Reporting
  • Linkage to external services