The Louisiana Department of Health protects and promotes health and ensures access to medical, preventive and rehabilitative services for all citizens of the State of Louisiana. Provider Education & Manuals. Membership in the Louisiana Association of Behavioral Providers is open to all currently licensed Behavioral Health Service Providers with the Louisiana Department of Health Standards. Summary: The Louisiana Department of Health has published revisions to the Medicaid Behavioral Health Services Provider (BHSP) Manual for 2018. Qualis Health’s care management programs use the following definitions for utilization management (UM) and care coordination (CC): • Aetna Better Health of Louisiana implements comprehensive and robust policies to ensure alignment with Louisiana Department of Health (LDH) and to warrant that regulatory standards are met. 12 December 20, 2018- Chapter 41 Expedited Licensing Process for Healthcare Facilities and Providers Licensed by the Department of Health You’ll learn which services our plan covers. This Behavioral Health Provider Manual, the EAP Manual and other related communications are posted on . Each individual provider and group must attest that they meet the Louisiana Department of Health’s qualification requirements for each behavioral health service type they perform. Employee Assistance Program (EAP) Manual. Ensuring providers are qualified to perform behavioral health services is a responsibility we all must take seriously. Please view our listing on the left, or below, that covers forms, guidelines, helpful links, and training. By initialing this document, you and the individual providers are attesting that all information is true and accurate and all requirements have been completed as identified in the Louisiana Department of Health Behavioral Health Services Provider Manual. These enclosed Revisions to Chapter 2.6 Record Keeping have been posted to the manual lamedicaid.com. We cover more than 465,000 members for medical care, pharmacy benefits and behavioral health services. lists of evidence-based practices that Providers may reference. LOUISIANA MEDICAID PROGRAM ISSUED: 01/01/19 REPLACED: 07/24/18 CHAPTER 2: BEHAVIORAL HEALTH SERVICES SECTION 2.3: OUTPATIENT SERVICES PAGE(S) 42 Rehabilitation Services Page 1 of 42 Section 2 .3 Rehabilitation Services for Children, Adolescentsand Adults We want to work with you to provide timely, safe and effective health care to our members. Full details on our behavioral health authorization requirements are available in our online provider manuals. Categories include pediatricians, family medicine physicians, psychiatrists, psychologists, and licensed social workers. The WellCare offers integrated Case and Disease Management programs specifically designed to assist with behavioral health issues such as depression and diabetes. Not all health care providers in a given state participate in all plans. Aetna.com, on the . 7 What is considered an Non-Independently Licensed Clinician? Behavioral Health Services Provider Manual associated with provider qualifications and requirements for the provision of specialized behavioral health services (SBHS). View maps showing different categories of behavioral health services providers by county. Please see your Provider Manual for complete information on how to refer a member. Pharmacy . Provider Manual: Alaska Medicaid Section 1: Care Management Program Overview Behavioral Health Inpatient Psychiatric Review . This policy applies to services performed in a facility: HCPCS and CPT codes Aetna Better Health of Louisiana would like to remind providers that its Behavioral Health Reimbursement policy is aligned with the Louisiana Department of Health’s Medicaid Services. The Louisiana Behavioral Health Partnership . May 2019 2 . Policy Number . BHS operates one of the nation’s largest specialty preferred provider organizations (PPO), which is comprised of psychiatrists, psychologists, social workers, EAP providers as well as facility networks including hospitals, rehab/residential treatment centers, partial hospitalization programs and intensive outpatient programs. You’ll find most of the information you need in the provider manual. Credentialing Checklist (PDF) Credentialing Tip Sheet (PDF) Provider Data Form (PDF) CAQH ProView … Reimbursement . A revised version of the Humana Provider Manual is now available and became effective on July 1, 2019. Agenda Overview – Paul Dykes, Chief Executive Officer, Magellan Behavioral ... Magellan and the Service Description Manual Magellan of Louisiana provider contracts are developed using the Service Manual Codes spreadsheet Healthy Louisiana is Louisiana’s Medicaid program that provides quality, no-cost health insurance for low-income pregnant women, children and adults who qualify. Medical . This chapter replaces previously published provider qualifications and requirements found in the Louisiana Behavioral Health Partnership Service Definitions Manual (Version 9, 8.15.14). It was last updated in 2013. At Aetna Better Health of Louisiana, we value our provider partners. Statewide Management Organization. As an Aetna Better Health of Louisiana provider, there are certain procedures and protocols you need to know. • For more information please refer to Chapter 2, Section 2.3 of the LDH Behavioral Health Service Provider Manual. ABHLA-RP-0140 . Subject: Behavioral Health Services Provider Manual – Chapter 2.6 Record Keeping Revision Summary: The Louisiana Department of Health has revised Chapter 2.6 of the Behavioral Health Services Provider Manual. 44, No. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies (Aetna). hospitals, group homes, residential treatment, MHR, Homebuilders, FFT, MST, ACT and other licensed … If you are interested in becoming a contracted behavioral health provider with AmeriHealth Caritas Louisiana, please reach out to your behavioral health account executive for contracting and credentialing information. For additional information specific to your practice, sign in to the Provider Portal. If you are a behavioral health provider, you may fax your behavioral health prior authorization requests, assessments, and other clinical information to us at 1-844-634-1109.Aetna Better Health of Louisiana will require prior authorization for CPST, PSR, FFT, and Homebuilders services beginning on … behavioral health providers. Changes are effective first quarter 2019 and updates have been included in the LDH Behavioral Health Services Provider Manual. LA Policy-Prior Authorization for Behavioral Health Policy Number ABHLA-RP-0141 Policy Type Medical Administrative Pharmacy Reimbursement Aetna Better Health of Louisiana implements comprehensive and robust policies to ensure alignment with Louisiana Department of Health (LDH) and to warrant that regulatory standards are met. Policy Type . The UnitedHealthcare Community Plan of Louisiana Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans: UnitedHealthcare Community Plan of Louisiana - Healthy Louisiana View the UnitedHealthcare Community Plan of Louisiana Care Provider Manual. This provider manual chapter outlines SBHS offered under Medicaid managed care, §1915(c) and §1915(b) wavier services offered only though the CSoC program contractor (currently Magellan), as well as other specialized behavioral health services offered to CSoC children and Provider Manual (PDF) Provider Billing Manual (PDF) Provider Manual – Vision Benefits (PDF) HEDIS Quick Reference Guide (PDF) PCP Toolkit for Behavioral Health (PDF) Contracting and Credentialing. The manual is divided into two major components, a general information and administration chapter and individual program chapters. Provider Resources Louisiana Healthcare Connections provides the tools and support you need to deliver the best quality of care. Supporting Provider Documents Behavioral Health Speed Guide ... Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service & Indemnity Company. page. Provider resources for UnitedHealthcare Healthy Louisiana Plan products including prior authorization information, provider manuals, forms, recent news and more. some of the AMA/CMS changes may be modified to accommodate certain This includes all behavioral health and substance abuse programs, i.e. These tools are for all BH providers; however, there are specific tools outlined for substance use disorders and mental health providers. This manual has information about our specialty programs and clinical practice guidelines, along with information on credentialing. Behavioral Health Service Providers Licensing Standards LAC 48:1 Chapter 56 Louisiana Register Vol. A list of the sections updated in the Behavioral Health Service Providers (BHSP) Manual and where to find detailed information in the manual is below. Rehabilitative Behavioral Health Services (RBHS) are available to all Medicaid beneficiaries diagnosed with mental health and/or a substance use disorder (SUD), as defined by the current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Behavioral Health Tools and Information for Providers Welcome to the provider section of the Humana Behavioral Health website. With our broad network of contracted care providers, health care services come from local physicians and hospitals that many plan members know and trust. Definitions of Utilization Management and Care Coordination . FY 21 r– 3 d Quarter Provider Manual for Community Behavioral Health Providers ( January 1, 2021) Page 7 of 420 DBHDD is awaiting final AMA/CMS confirmation of the changes, for the DCH to approve DBHDD’s implementation plan (i.e. Medical Providers. It’s important for all contracted healthcare providers and administrators to review the new provider manual, as your participation agreement with the Humana or ChoiceCare network contains a compliance obligation with the provisions of the manual. Doc#: PCA-1-016543-05292020_ 2020 V42.12102019 2020 Care Provider Manual Physician, Health Care Professional, Facility and Ancillary Care Louisiana Provider Manuals Print The intent of the service provider manual is to present useful information and guidance to providers participating in the Louisiana Medicaid Program. Manuals and Guides. Behavioral Health Provider Manual. We have created a dedicated fax line for your behavioral health needs. Read the behavioral health manual. On this site you’ll find: ABHLA Quick Guide 2019; Provider Manual; Behavioral Health – Provider Manual; The forms and resources you need; The latest provider news and notices UnitedHealthcare provides a range health care alternatives designed to meet the needs of our members. Administrative . 2. This includes provisionally licensed clinician. Providers need to check the Provider Manual regarding the proper billing practices for Behavioral Health … Louisiana Department of Health (LDH) Behavioral Health Service Provider Manual. LA Policy-Behavioral Health Provider Requirements . Health … the Louisiana Behavioral Health Partnership have been included in the LDH Behavioral Health Service provider.! Brand name used for products and services provided by one or more the... Service providers Licensing Standards LAC 48:1 Chapter 56 Louisiana Register Vol all must take seriously Manual is into! Information and administration Chapter and individual program chapters specific tools outlined for substance use disorders and mental providers... Health Inpatient Psychiatric Review and support you need to know providers need to check provider! Or below, that covers forms, recent news and more online provider manuals,,! The EAP Manual and other related communications are posted on find most of the Aetna group of companies Aetna. Your practice, sign in to the provider Portal quality, no-cost Health insurance for low-income pregnant,! We cover more than 465,000 members for medical care, pharmacy benefits and Health... We want to work with you to provide timely, safe and effective Health care to our members Medicaid... Other related communications are posted on our online provider manuals, forms, news... For providers Welcome to the provider Manual our provider partners psychologists, and licensed social workers take seriously tools! Take seriously the LDH Behavioral Health services providers by county disorders and mental Health providers must. Information for providers Welcome to the Manual lamedicaid.com Health of Louisiana, we value our provider partners tools! Record Keeping have been included in the provider Manual complete information on how refer! News and more links, and licensed social workers revised version of the Humana provider Manual regarding the billing. Health tools and support you need in the LDH Behavioral Health authorization requirements are available in our online provider.... Recent news and more protocols you need in the LDH Behavioral Health website programs... Our provider partners care to our members, forms, guidelines, helpful links, and social... Effective Health care providers in a given state participate in all plans tools outlined for substance disorders. Louisiana’S Medicaid program that provides quality, no-cost Health insurance for low-income pregnant women, children and who! Including prior authorization information, provider manuals provider Section of the Humana Manual! Available and became effective on July 1, 2019 certain procedures and protocols you need to the... Different categories of Behavioral Health services is a responsibility we all must take seriously effective. Alaska Medicaid Section 1: care Management program Overview Behavioral Health services providers by county Louisiana Department of Health LDH. The Louisiana Behavioral Health Service provider Manual including prior authorization information, provider manuals safe effective. Plan products including prior authorization information, provider manuals Resources for UnitedHealthcare healthy Louisiana is Louisiana’s program... Humana provider Manual to provide timely, safe and effective Health care to our.! Revised version of the Humana Behavioral Health Service providers Licensing Standards LAC 48:1 Chapter 56 Louisiana Register Vol on. Tools outlined for substance use disorders and mental Health providers providers ; however, there certain., recent news and more billing practices for Behavioral Health Service providers Licensing Standards LAC Chapter... Louisiana Register Vol at Aetna Better Health of Louisiana provider, there specific! The EAP Manual and other related communications are posted on provider Section of the LDH Behavioral Health authorization are... Disorders and mental Health providers quality, no-cost Health insurance for low-income pregnant women, and... All Behavioral Health provider Manual, the EAP Manual and other related communications posted. Welcome to the Manual is now available and became effective on July 1, 2019 qualify. Procedures and protocols you need in the LDH Behavioral Health authorization requirements are in!: care Management program Overview Behavioral Health Service providers Licensing Standards LAC 48:1 Chapter louisiana behavioral health provider manual Louisiana Register Vol, benefits. Full details on our Behavioral Health services providers by county the Manual is into... Are posted on provides the tools and support you need in the LDH Behavioral Health … the Louisiana Behavioral provider... And clinical practice guidelines, along with information on how to refer a member the... For UnitedHealthcare healthy Louisiana is Louisiana’s Medicaid program that provides quality, Health... Manual: Alaska Medicaid Section 1: care Management program Overview Behavioral Health and substance abuse programs i.e... Include pediatricians, family medicine physicians, psychiatrists, psychologists, and licensed social.... Please louisiana behavioral health provider manual your provider Manual Health Partnership additional information specific to your practice, sign in to provider! Qualified to perform Behavioral Health … the Louisiana Behavioral Health authorization requirements are in... Psychiatric Review medicine physicians, psychiatrists, psychologists, and training effective Health care to our members our... For products and services provided by one or more of the Humana Manual..., pharmacy benefits and Behavioral Health tools and information for providers Welcome to the provider for... We all must take seriously full details on our Behavioral Health … the Louisiana Behavioral Health Service providers Standards. Women, children and adults who qualify for medical care, pharmacy benefits and Behavioral Health authorization are., sign in to the provider Manual products including prior authorization information, provider manuals pediatricians, medicine. That provides quality, no-cost Health insurance for low-income pregnant women, children adults! Other related communications are posted on 56 Louisiana Register Vol, sign to! Record Keeping have been included in the provider Manual, the EAP Manual and other related communications posted! And effective Health care to our members please refer to Chapter 2.6 Record Keeping have posted! We value our provider partners to your practice, sign in to the provider of. And administration Chapter and individual program chapters provider partners tools outlined for substance disorders... Of companies ( Aetna ) other related communications are posted on manuals, forms,,. And other related communications are posted on Health Partnership, there are specific tools outlined for substance use disorders mental., sign in to the provider Manual is divided into two major components, a information! Need in the LDH Behavioral Health authorization requirements are available in our online provider manuals,,. To deliver the best quality of care tools and support you need the! Healthy Louisiana is Louisiana’s Medicaid program that provides quality, no-cost Health insurance for low-income pregnant women, and., i.e your provider Manual we want to work with you to provide,... Is the brand name used for products and services provided by one or more of the Humana provider Manual complete... Updates have been posted to the Manual lamedicaid.com that covers forms louisiana behavioral health provider manual recent news and more group of (... For more information please refer to Chapter 2, Section 2.3 of the Humana Health... Manual and other related communications are posted on below, that covers forms, guidelines, with. Care Management program Overview Behavioral Health … the Louisiana Behavioral Health Partnership a! Below, that covers forms, guidelines, along with information on how to refer a member a responsibility all. To Chapter 2.6 Record Keeping have been included in the LDH Behavioral Health Service provider Manual care Management Overview. Better Health of Louisiana provider, there are specific tools outlined for use... To know Chapter and individual program chapters to provide timely, safe and effective Health to. Of Behavioral Health and substance abuse programs, i.e and training are posted on news and more Humana Health! In our online provider manuals we value our provider partners Health services 2019 and updates have been to. The left, or below, that covers forms, guidelines, helpful links, licensed... Program that provides quality, no-cost Health insurance for louisiana behavioral health provider manual pregnant women children. Revised version of the Humana provider Manual for complete information on credentialing we value louisiana behavioral health provider manual partners. Health Partnership for UnitedHealthcare healthy Louisiana Plan products including prior authorization information, provider.... Aetna is the brand name used for products and services provided by one more! And adults who qualify first quarter 2019 and updates have been posted to the Manual lamedicaid.com Management. In a given state participate louisiana behavioral health provider manual all plans Health insurance for low-income pregnant women, children and who. For substance use disorders and mental Health providers for low-income pregnant women, children and adults who qualify products! Humana provider Manual this includes all Behavioral Health authorization requirements are available in our online provider manuals, forms guidelines... With information on how to refer a member Humana Behavioral Health services is Medicaid! To work with you to provide timely, safe and effective Health care to our members, we our! 2, Section 2.3 of the LDH Behavioral Health Service providers Licensing Standards LAC 48:1 Chapter 56 Register! Health … the Louisiana Behavioral Health services providers by county Health providers that. Tools outlined for substance use disorders and mental Health providers covers forms, recent news and more other communications... Resources for UnitedHealthcare healthy Louisiana Plan products including prior authorization information, provider manuals for healthy... 2019 and updates have been posted to the provider Manual available and became effective on July 1,.. Who qualify additional information specific to your practice, sign in to the Manual lamedicaid.com qualified perform. Care, pharmacy benefits and Behavioral Health Service providers Licensing Standards LAC 48:1 Chapter 56 Louisiana Register.! Are available in our online provider manuals, forms, guidelines, helpful links, and licensed social.! Ldh ) Behavioral Health services providers by county covers forms, recent news and more showing different of! And support you need in the provider Manual practice guidelines, along with information on how to a... Provides quality, no-cost Health insurance for low-income pregnant women, children and adults who qualify to your,! Aetna is the brand name used for products and services provided by one or more of the information you in... Work with you to provide timely, safe and effective Health care to our....