State of Maryland Department of Health and Mental Hygiene & V ALUE O PTIONS ® September 2009 Clinical Training For Non-OMS Providers

2 Welcome to ValueOptions ®

Presenters Nancy Calvert, Director, ValueOptions® Maryland Provider Relations Jennifer Lowther, ValueOptions ® Maryland Clinical Director

Agenda Update Overview of ProviderConnect Requesting Authorizations Questions

Updates ValueOptions® Maryland Website – Provider Alerts MHA Policy Clarification Memos and Announcements ValueOptions® Maryland Updates and Announcements – Training Schedule – ProviderConnect “tips” – Maryland Specific ProviderConnect “demo” – Provider Forms – including a hard copy concurrent review form – Coming Soon: Provider Manual Diagnostic Crosswalk Fee Schedule Service Grid – Consumer Information

Important Information Initial Authorization Requests – A diagnosis is not required. You may enter ICD-9 Code “unspecified diagnosis” for the initial request. – Initial requests will auto-authorize for 12 visits/6 months. Providers do not need to call to request an additional 6 months. This will be automatically updated by ValueOptions® Maryland to 12 visits/12 months. Concurrent Authorization Requests – Treatment plans should be attached via the attachment option. – Concurrent authorization requests will default to 24 visits. If more are required, please indicate the number requested in the treatment plan and include the clinical justification for the request. Occupational Therapy/Psychological Testing/ECT: – Authorization requests must be called in to ValueOptions® Maryland:

Services Authorized for Outpatient Therapy 90801: Initial Evaluation 90804: Individual Psychotherapy (20-30 minutes) 90805: Individual Psychotherapy with Med Eval/Mgmt 90806: Individual Psychotherapy (40-50 minutes) 90807: Individual Psychotherapy with Med Eval/Mgmt 90846: Family Psychotherapy without Patient Present 90847: Family Psychotherapy with Patient Present 90849: Multiple Family Group 90853: Group Therapy 90862: Medication Management 90875: Individual Psychotherapy with Biofeedback 90876: Individual Psychotherapy with Biofeedback T1015: FQHC Clinic Visit

ProviderConnect 8

ValueOptions ® ProviderConnect Free, secure, online application Easy access 24 hours a day, 7 days a week Complete multiple transactions in a single sitting ProviderConnect is an online tool that increases convenience & decreases administrative burden.

ValueOptions ® ProviderConnect Features Verify Consumer eligibility Register Uninsured Consumers Request Authorizations View Authorizations Submit Claims (Batch and Direct/On-line claim) View Claim Status View and Print Provider Summary Voucher Submit inquiries to Customer Service Access and print forms With ProviderConnect providers can:

Accessing ProviderConnect Each provider has a secure login and online registration, including a provider ID number via the ProviderConnect Web site. Additional logins for other providers in the same practice are available through ProviderConnect. Contact: ValueOptions ® EDI Helpdesk (888) , Option 3 Monday through Friday 8 a.m. – 6 p.m. EST Turn around time for additional logins is 48 hours.

September 25 th Upgrade Online Uninsured Eligibility Registration (request function) is now available to providers. Axis 1-V diagnoses are now required on concurrent reviews The “Individual Care Plan” – The Plan tab has been added to the Mobile Treatment authorization request screen. – The Service Code Field has been removed – Providers now have the option to print the Plan separately. “MCO” is no longer a required field. “Education Level” has been deleted from the federally required questions. “N/A” is no longer an option to the “Race” question.

Requesting an Authorization Non-OMS Outpatient Therapy

14 Questions

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