Utilization Management (UM) Best Practices for Psychiatric Residential Treatment Facilities (PRTFs)

Developed in partnership with the clinical team at the Children’s Mental Health Bureau of the Developmental Services Division at Montana Medicaid’s Department of Public Health and Human Services (DPPHS), this training includes a live demo of best practices for submitting through the MCG portal within Qualitrac. Mountain-Pacific Quality Health and Telligen, the UM review contractor team, share best practices and lessons learned and review medical necessity criteria to help reduce frequency of requests for information and improve efficiencies during the review process.

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hello, quick question: Is the criteria/guidlines that the client needs to meet from the state or from the insurance company? Thank you! wonderful video