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2016-07: Behavioral Health Authorization Requirements by Service Type

Date: 02/17/16

Louisiana Healthcare Connections (LHCC) has sent out previous communication to providers with a crosswalk, indicating Magellan authorization numbers, the corresponding new LHCC authorization numbers, start dates and end dates.

Some of these end dates are 2/29. For authorizations with end dates 3/1 and later, LHCC will honor the authorization until the previously stated end date unless and until a notice of determination is made by LHCC to the contrary (in accord with DHH policy beginning in March 2016).

Please continue to submit clinical documentation for these members as it enables the LHCC behavioral health team to establish a baseline for these members. The specific clinical information for each service category and population type is outlined below.

IMPORTANT Submission Requirements: When submitting the documentation for clinical review, an assessment and treatment plan must be included initially and only annually thereafter.  If these were completed within one (1) calendar year, the assessment and treatment plan does not need to be updated, but rather the provider can submit the current assessment with the OTR. If the previous assessment and treatment plan is older than one year, a new assessment and treatment plan must be included with the OTR.

ADULT – Legacy MHR Services (CPST, PSR, Crisis Intervention, etc.)

  • Bayou Health Behavioral Health Assessment Form (Formerly 1915i Form)
  • LOCUS Score Sheet
  • Treatment plan (Provider may use their own version or the sample provided on the LHCC website) NOTE: Provider must submit the treatment plan within 30 days following the completion of the initial assessment or annual reassessment
  • Outpatient Treatment Request Form
  • Any additional clinical information to support request.
  • See above IMPORTANT Submission Requirements.

CHILD/ADOLESCENT - Legacy MHR Services (CPST, PSR, Crisis Intervention etc.)

  • Outpatient Treatment Request Form
  • Any additional clinical information the provider deems necessary to support request, which may include the assessment and Treatment plan.

See above IMPORTANT Submission Requirements.

Assertive Community Treatment (ACT)

  • Bayou Health Behavioral Health Assessment Form (Formerly 1915i Form)
  • LOCUS Score Sheet
  • Treatment plan (Provider may use their own version or the sample provided on the LHCC website) NOTE: Provider must submit the treatment plan within 30 days following the completion of the initial assessment or annual reassessment
  • Outpatient Treatment Request Form
  • See above IMPORTANT Submission Requirements.

Professional Services Provided By LMHPs

  • Non-Participating Providers require Outpatient Treatment Request for all services except crisis.

Note: Crisis Services do not require all of the above. Please see your Louisiana Healthcare Connections provider manuals for details.

Authorizations may be faxed to: 1-844-466-1277 or submitted via the secure web portal: https://provider.louisianahealthconnect.com.

All forms, documents and more information can be found at www.LaHealth.CC/BHResources.