Updated Network Manual Now Available 

An updated California Network Manual  is now available for Optum Behavioral Health providers.  If you’ve downloaded a copy of the manual, please replace it in your files. If you’ve saved a link to the manual, please update it. 

All of the newest changes are summarized in the Change Index on page 4 of the manual.

Key changes:

• Appointment availability:  Time-to-appointment standards have been split out to present information for Commercial, Medicare and Medicaid plans separately. Requirements and process for indicating whether you are accepting new patients and when to report unavailable status (usually due to a leave of absence) have also been clarified. 

• Demographic updates:  There are 2 ways to submit changes to a provider’s demographic updates – through the Provider Express secure portal or by calling the Provider Services Line. Demographic updates include items such as the office phone number, locations where you see patients, whether you’re accepting patients’ status, areas of expertise, etc. 

• Billing: Clarified billing for MH/SUD services not performed by provider when allowed by contractual agreement or regulatory requirements  

• Added new DMHC criteria for Qualified Autism Service Professional 

• Applied Behavioral Analysis (ABA): Added link to new ABA webpage on Provider Express and new path to request authorization for Assessment.  Added certification requirements for ABA paraprofessionals and behavior technicians

• Outpatient Care Engagement (OCE): Added OCE language to Clinical Outcomes Models

• Practice Management section updated 

• Complex Case Management (CCM): Added screening tools used for CCM program

• Psychological Testing: Clarified pre-authorization requirements and billing requirements for inpatient or facility admission

• Psychological Assistants and Interns section updated and moved to Benefit Plans section

• Medical Records: Added information to clarify requirements and timelines to respond to medical record request requests in a timely manner

• ACE Clinicians removed  - This program has ended, and information has been removed from the manual.

Questions? 

Call Provider Services at 1-877-614-0484.