KanCare Training for Providers - Ubhonline.com

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Optum Philosophy of Care A managed care plan that features: • An integrated medical and behavioral health delivery system • A focus on member involvement in identifying his or her needs • Support for collaboration Six key goals: 1. Improve screening and treatment of mental health and substance use disorder diagnoses 2. Treat individuals at the point of care where they are comfortable 3. Treat individuals in a holistic manner, using a single treatment plan, helping each individual access his/her natural community supports based on personal strengths and preferences 4. Improve communication and collaboration between behavioral health and medical clinicians 5. Operate with a collaborative team approach to deliver care using a standardized protocol 6. Establish the necessary permissions from the individual to coordinate care Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 4
Behavioral Health Services
Page 1 and 2: KanCare Training for Providers Optu
Page 3: Introduction to Optum • United Be
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 and 38: Provider Responsibilities • Provi
Page 39 and 40: Optum Provider Website • Provider
Page 41 and 42: Network Participation
Page 43 and 44: Joining Our Network If you have rec

KanCare Training for Providers - Ubhonline.com

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