Welcome to the Optum Network!

• WA UnitedHealthcare Community Plan 2023 Care Provider Manual
  

• WA IMC Educational Announcements: December 2019
  
• WA Integrated Managed Care Provider Training
• MCO IMC Claims Encounter Process Flow
  
• WA IMC Crticial Incident Handout
  
• Salish MCO ASO PA Provider Services Reference Guide
  
• Salish IMC Clinical Provider Presentation
  
• Salish IMC Operations Provider Presentation
  
• NPI IMC Fact Sheet
• Thurston Mason and Great Rivers Integrated Managed Care Operations Symposium
  
• HCA Medicaid Updates Related to Tribal Health presentation
  
• HCA Interpreter Services Program presentation
  
• HCA Non-Emergency Medical Transportation presentation
  
• Claims and Encounter Process Flow Chart
  
• Great Rivers Region MCO & BH-ASO Prior Authorization Guide
  
• Thurston Mason Region MCO & BH-ASO Prior Authorization Guide
  

Shared Decision-making and Behavioral Health Interventions for Patients with Depression
Recorded October 18, 2019

This webinar features experts from the University of Washington Advancing Integrated Mental Health Solutions (AIMS) Center leadership discussing evidence-based strategies and interventions for removing common barriers of initiation and continuation of recommended treatment when caring for patients with depression.
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Delivering Suicide Safe Care
Recorded October 22, 2019

This webinar features experts in the Western Washington region highlighting key elements of the Bree Collaborative suicide safe care recommendations.
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Center of Excellence Launch: Resources and Tools for Enhancing Integrated Care
Recorded November 20, 2019

The National Council for Behavioral Health, through the National Center of Excellence for Integrated Health Solutions (CIHS) grant award from the Substance Abuse and Mental Health Administration (SAMHSA), is pleased to announce the launch of the Center of Excellence for Integrated Health Solutions. The Center of Excellence for Integrated Health Solutions will provide ongoing education and provider training on different models of integrated care.

This webinar provides an overview of the Center and discusses ways to collaborate on the dissemination of training and technical assistance.
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Common Behavioral and Physical Health Co-Morbidities
Recorded December 2, 2019

The webinar will feature experts in the Western Washington region and highlight key elements of behavioral and physical health care assessment and integrated care planning.
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Behavioral Health Integration for Primary Care Providers
Recorded December 12, 2019

This provides an overview of the Bree Collaborative recommendations for integration of behavioral health in primary care standards implementation for pediatric and adult primary care practices and perspectives from providers that have adopted these recommendations in their care delivery models.
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Center of Excellence – Collaborative Care: Strategies for Unlocking Its Potential
Recorded December 18, 2019

This webinar provides vital information about the detrimental effects of how collaborative care is one of the most effective interventions for depression, anxiety disorders, and co-occurring medical conditions. The on-demand recording offers practical strategies to implement collaborative care clinical practices to conduct depression screening and regular tracking, create an organizational culture that empowers staff to improve clinical and financial outcomes, and adhere to procedures from the landmark IMPACT depression study.
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WA Integrated Managed Care Medicaid Level of Care Guidelines

SBIRT

Screening, Brief Intervention, and Referral to Treatment Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. The SBIRT model was incited by an Institute of Medicine recommendation that called for community-based screening for health risk behaviors, including substance use. https://www.integration.samhsa.gov/clinical-practice/sbirt

GAIN-SS

The Global Assessment of Individual Needs-Short Screener (GAIN-SS) is an evidence-based, five-minute screening tool for general populations to identify clients who have one or more behavioral health disorders.

Overview: The 5-minute GAIN-Short Screener (GAIN-SS) is designed primarily for 3 things: 1)  it serves as a screener in general populations to quickly and accurately identify clients (also known as patients, respondents, or research participants) whom the full 1.5 to 2-hour GAIN-Initial would identify as having 1 or more behavioral health disorders (e.g., internalizing or externalizing psychiatric disorders, substance use disorders, or crime/violence problems), which would suggest the need for referral to some part of the behavioral health treatment system. It also rules out those who would not be identified as having behavioral health disorders; 2) it serves as an easy-to-use quality assurance tool across diverse field-assessment systems for staff with minimal training or direct supervision; 3) it serves as a periodic measure of change over time in behavioral health.

GAIN-SS Forms are available by clicking the following links:

• GAIN-SS target data elements setup form (14-479)
• GAIN-SS target data elements admission and assessment form (04-416)

GAIN-SS  copyright  ©  Chestnut  Health  Systems.  For  more  information  on  the  instrument,  please  visit http://www.gaincc.org or contact the GAIN Project Coordination Team at (309) 451-7900 or GAINInfo@chestnut.org

Washington State Health Care Authority links for billers, provider and partners

BREE Collaborative

In 2011, Dr. Robert Bree established a collaborative forum comprised of public and private stakeholders. The group combine efforts and expertise to identify and recommend evidence-based strategies, which improve quality of care, improved health outcomes through the delivery of integrated health care. Behavioral health care integrated into primary care is one of the leading focuses of the Bree Collaborative which has been not only efficient in the delivery of best practice treatment is has shown to be a cost-effective model of care.

Use of evidence-based, existing models of assessment and eight elements are incorporated to define a minimum standard to promote integrated care in the Bree Collaborative Model. Washington State has adopted the elements of best practice by incorporating the eight elements of the Bree Collaborative as an initiative to bridge evidence-based management that allows all health care providers the basis to achieve integrated care services. Use of the following eight elements, with specified criteria, allow the patient to be the full focus of care delivery, promote care that becomes standard, by encompassing the full perspective of integration of medical and behavioral wellbeing.

1. Integrated Care Team

2. Patient Access to Behavioral Health as a Routine Part of Care

3. Accessibility and Sharing of Patient Information

4. Practice Access to Psychiatric Services

5. Operational Systems and Workflows to Support Population-Based Care

6. Evidence-Based Treatments

7. Patient Involvement in Care

8. Data for Quality Improvement

For additional criteria to engage the Bree Collaborative, please resource the full document: The Bree Collaborative (2017)

Recovery and Resiliency Toolkit for Providers

Intellectual and Developmental Disabilities (I/DD) Toolkit

Transitions of Care Resources

Behavioral Health Toolkit for Medical/Behavioral Providers

AIMS - Collaborative Care

Collaborative care is a specific type of integrated care developed at the University of Washington that treats common mental health conditions such as depression and anxiety that require systematic follow-up due to their persistent nature. Based on principles of effective chronic illness care, collaborative care focuses on defined patient populations tracked in a registry, measurement-based practice and treatment to target. Trained primary care providers and embedded behavioral health professionals provide evidence-based medication or psychosocial treatments, supported by regular psychiatric case consultation and treatment adjustment for patients who are not improving as expected. https://aims.uw.edu/collaborative-care

Washington State Healthcare Authority (WSHA): Evidence-based and research-based practices

The Northwest MHTTC: Mental Health Technology Transfer Center Networks

Washington Apple Health Integrated Managed Care Intake Request Fax Form

Critical Incident Report Form 

WA IMC Justice Release Honor Auth Inquiry

WA IMC Managed Care BH Prior Authorization Request

Chapter 12: Claim Reconsiderations, Appeals and Grievances