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Medicaid Managed CareBehavioral Health Concurrent Review Form for Inpatient, RTC, PHP and IOP Instead of faxing this form, submit your request electronically using our preferred method at HTTPS://www.availity.com.*

How to fill out behavioral health concurrent review

How to fill out behavioral health concurrent review

1. Gather all necessary information about the patient's behavioral health condition.
2. Contact the insurance provider to verify if behavioral health concurrent review is required for the specific treatment.
3. Obtain the necessary forms or documentation for conducting the behavioral health concurrent review.
4. Fill out the forms or documentation accurately and completely, providing all relevant information about the patient's condition and treatment plan.
5. Submit the completed forms or documentation to the appropriate entity for review.
6. Follow up with the insurance provider or reviewing entity to ensure the review process is progressing adequately.
7. Address any additional requests for information or clarification from the reviewing entity promptly.
8. Await the decision and outcome of the behavioral health concurrent review.
9. If approved, proceed with the recommended treatment plan.
10. If denied, evaluate the reasons for denial and consider appealing the decision if appropriate.
11. Make any necessary modifications to the treatment plan based on the outcome of the review.

Who needs behavioral health concurrent review?

1. Individuals who require behavioral health services, such as therapy or psychiatric treatment, may need to undergo behavioral health concurrent review.
2. Insurance providers often require this review to determine the medical necessity and appropriateness of the treatment being provided.
3. Both inpatient and outpatient behavioral health services may require concurrent review to ensure quality care and proper resource utilization.
4. It is essential to consult with the insurance provider or the specific behavioral health facility to determine if concurrent review is necessary for a particular treatment or service.

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What is behavioral health concurrent review?

Behavioral health concurrent review is a process used by insurance companies to determine the medical necessity and appropriateness of behavioral health services in real-time.

Who is required to file behavioral health concurrent review?

Behavioral health providers, such as therapists, counselors, and psychiatrists, are required to file behavioral health concurrent review.

How to fill out behavioral health concurrent review?

To fill out a behavioral health concurrent review, providers must submit information about the patient's diagnosis, treatment plan, progress, and any other relevant documentation.

What is the purpose of behavioral health concurrent review?

The purpose of behavioral health concurrent review is to ensure that patients are receiving the appropriate level of care and to minimize unnecessary or excessive treatments.

What information must be reported on behavioral health concurrent review?

Information reported on behavioral health concurrent review includes patient demographics, diagnosis, treatment plan, progress notes, and any relevant test results or assessments.