KanCare Training for Providers - Ubhonline.com

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Behavioral Medical Integration OUR GOAL is to increase medical and behavioral health care integration for all members. Clinicians are asked to refer members with known or suspected and untreated physical health problems or disorders to their Primary Care Physician for examination and treatment. OUR GOAL is to increase integration of treatment for mental health and substance use disorder conditions. Our care management program to there to assist members with complex medical and/or behavioral health needs in the coordination of their care. Members are expected to be treated from a holistic standpoint, this is especially true for high-risk, high-service utilizers and other high-cost individuals with complex needs. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 38
Optum Provider Website • Providerexpress.com includes both public and secure pages • Public Pages include general updates and other useful information – Download standard forms (Ex. Agency Roster Update form) – Find staff contacts – Review clinical guidelines and the KanCare Network Manual – Access current and archived issues of Network Notes, the provider newsletter • Secure pages are available only to network providers and require registration – KanCare providers will be able to update their practice information Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 39
Page 1 and 2: KanCare Training for Providers Optu
Page 3 and 4: Introduction to Optum • United Be
Page 5 and 6: Behavioral Health Services
Page 7 and 8: Behavioral Services • Inpatient H
Page 9 and 10: Value Added Services - continued
Page 11 and 12: Pre-Specified Initial Authorization
Page 13 and 14: Authorization Non-emergent situatio
Page 15 and 16: Eligibility and Benefit Review Proc
Page 17 and 18: Appeals and Grievances
Page 19 and 20: Services While In Appeal • You ma
Page 21 and 22: Treatment Record Documentation
Page 23 and 24: Discharge Planning • Effective di
Page 25 and 26: Billing and Claims
Page 27 and 28: Claims Tips To ensure clean claims
Page 29 and 30: Member Information
Page 31 and 32: Member Rights and Responsibilities
Page 33 and 34: Provider and Member Resources An ex
Page 35 and 36: Access to Care - Standards Routine
Page 37: Provider Responsibilities • Provi
Page 41 and 42: Network Participation
Page 43 and 44: Joining Our Network If you have rec

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