Behavior Health
These types of authorizations can be build over the phone for BH.....
What is Inpatient authorization?
Retro determination time frame...
What is 30 calendar day TAT or a determination from date received?
This authorization is set up with a 3 month span and have a 10 business day grace period.
What is Genetic Testing?
Vision services need to be verified by.....
What is Envolve Vision Services?
This is needed to file an appeal for denied authorizations......
What is a written request, clinical, and member consent form?
All GA Medicaid BH request are to be submitted.....
What is in GAMMIS?
Appeals time frame.....
What is 30 calendar days?
This type of authorization have a same day service and a 5 business day grace period.
What is Transportation?
Dental services, (D0000-D9999), need to be verified by...
What is Envolve Dental?
This tool is use to check procedure codes....
What is pre-auth check tool?
If they are having issues with GAMMIS, BH can do this....
What is fax request?
Retro processing time frame....
What is 60 to 90 day processing time?
Prior to the Health Plan reviewing a Retrospective request, the Provider must.....
What is submit a claim for payment?
Complex Imaging, MRA, MRI, PET, CT Scans need to be verified by....
What is NIA?
You can find RadMD, Envolve Pharmacy Solutions, Envolve Vision, Georgia Medicaid Management Information System (GAMMIS) and others under this.....
What is Helpful Links?
It’s very important to check providers when building BH authorizations to use....
What is CBH National PROD in Amisys?
Urgent/Concurrent
What is 24 clock hours?
The Provider will receive an EOB with a notification of failure to obtain prior authorization. The Provider must then submit...
What is a claim reconsideration or claim appeal?
Musculoskeletal, ENT and Cardiac Services need to be verified by....
What is TurningPoint?
All oncology-related medical and radiation treatments and supportive care will be submitted to....
What is New Century Health?
BH Providers should mention this when faxing in PA request instead of inputting on the portal....
What is it must be stated they are having issues with GAMMIS on fax?
Time frame for New Request for Authorization....
What is 60 days from auth denial date and/or 60 day from appeal denial date?
This type of authorization is set for 1 month span and have a 10 business day grace period...
What is Drug Testing?
Behavioral Health/Substance Abuse need to be verified by....
What is Peach State Health Plan?
Peach State Health Plan providers must keep accurate and complete...
What is medical records?