Behavioral Health Utilization Management Review

Behavioral Health Utilization Management Review Policy

Attachment: 2021 Quality Monitoring Plan

Attachment: Dual Eligible MHL Guidelines

Attachment: DWIHN Access Center Flow Chart

Attachment: DWIHN Clinical Case Record Review Tool

Attachment: DWIHN Eligibility Service Review Tool

Attachment: DWIHN Prior Authorized Service UM Chart Review Tool

Attachment: IRO Physician Reviewer Documentation Form

Attachment: IRO Referral Review Request Form

Attachment: MHL Out of Network Outpatient Treatment Review Form

Attachment: Physician Review Form

Attachment: SMI-IDD-SUD Out of Network OTR Form

Attachment: UM Decision Turn Around Times for Initial Determinations

UM Provider PRocedures for Behavioral Health Services Routinely Not Requiring Auth for MI Health Link