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Provider BULLETIN
March 11, 2016Behavioral Health Retro Authorization Process
After a Claim Has Been Denied for No Authorization on File
A June 2015 Care Provider Bulletin outlined changes to mental
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What is behavioral health retro authorization?
Behavioral health retro authorization is a process where a request for mental health or substance abuse services is approved after the services have already been provided.
Who is required to file behavioral health retro authorization?
Healthcare providers and facilities are typically required to file behavioral health retro authorization.
How to fill out behavioral health retro authorization?
To fill out behavioral health retro authorization, providers must include patient information, treatment details, and authorization request.
What is the purpose of behavioral health retro authorization?
The purpose of behavioral health retro authorization is to ensure that the services provided were medically necessary and meet the criteria for reimbursement.
What information must be reported on behavioral health retro authorization?
Information such as patient's diagnosis, treatment plan, dates of service, and provider information must be reported on behavioral health retro authorization.
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