Utilization Management

Welcome to Utilization Management! 1-1 ACBHD Utilization Management Division Description SPECIALTY MENTAL HEALTH DELIVERY SYSTEM 1-2 Acute Inpatient Authorization Requests Acute Inpatient Hospital Concurrent Review Changes Memo Inpatient Authorization Request Form 1-3 Adult Residential Treatment and Crisis Residential Treatment Provider Authorization Requests 1603-6 “Concurrent Review of Crisis Residential Treatment Services and Adult Residential Treatment Services” (10/07/22) SMHS Adult Residential Treatment Service Authorization Request Form: DOCX | PDF SMHS Crisis Residential Treatment Service Authorization Request Form: DOCX | PDF Level of Care Determination Tool for Residential Providers: DOCX | PDF ART Training - This training covers the regulations for Adult Residential Specialty Mental Health Services programs governing the authorization process with Utilization Management and clinical documentation standards. Crisis Residential Authorization and Documentation Training SMHS - This training covers the regulations for Crisis Residential Specialty Mental Health Services programs governing the authorization process with Utilization Management and clinical documentation standards. 1-4 Day Treatment Day Rehabilitation & Day Treatment Intensive Service Authorization Request Form 200-3 “Prior Authorizations for Day Rehabilitation and Day Treatment Intensive” (10/22/22) 1-5 Eating Disorder Authorization Requests (Including MHIP) 406-1-1 Eating Disorders (12/16/19) MHS FFS Eating Disorder Services Utilization Table Prior Payment Authorizations (Please refer to Prior Payment Authorization section within + MHIP Handbook) Utilization Table for Fee for Service Individual and Organizational Providers- Effective July 1, 2024 - 9/3/24 1-6 Interventional Service Authorization Requests Policy and Procedure In the process of development ***In the process of development Referral Form and Authorization Request Form DOCX | PDF 1-7 Service Authorization Requests for initial or continuing authorization (Youth Service Authorizations) Authorization of Services for Kin-GAP and AAP populations (forthcoming) Service Authorization Request Form DRUG MEDI-CAL ORGANIZED DELIVERY SYSTEM (DMC-ODS) 2-1 Substance Use Residential Treatment Provider Authorization Requests Drug Medi-Cal Organized Delivery System (DMC-ODS) Requirements for the Period of 2022 – 2026” (5/13/22) Authorizations of Substance Use Residential Treatment Services under Drug Medi-Cal – Organized Delivery System (DMC-ODS) DMC-ODS Residential Treatment Authorization Request Form Documenting Medical Necessity for ASAM Residential Level 1 Training Slide Dec PUBLIC REPORTING 3-1 Prior Authorization Metrics 2025 Prior Authorization Metrics (updated March 26, 2026)