CALMHSA
Psychiatric Inpatient Concurrent
Review and Authorization
Concurrent review and authorization for psychiatric
inpatient hospital and psychiatric health facility services
on behalf of multiple California county Mental Health Plans
(MHPs) through the California Mental Health Services Authority
(CalMHSA)
About Our Program
California Inpatient Psychiatric Hospital Concurrent Review
On May 13, 2019, the Department of Health Care Services (DHCS) released a Behavioral Health Information Notice (BHIN) to inform all County Mental Health Plans (MHPs) that they must develop a concurrent review and authorization process for all psychiatric inpatient hospital services, to be enforced on July 1, 2022. Effective April 1st, 2022, Acentra Health, in coordination with the California Mental Health Services Authority (CalMHSA), will be working with the county MHPs that have agreed to participate in this program.
- Receives notification of admission and request
for treatment authorization - Conducts concurrent clinical reviews to determine
medical necessity - Facilitates care coordination and discharge planning
- Provides notices of denials and adjudications appeal requests
- Prepares reporting and analysis of relevant hospitalization
variables - Conducts internal quality assurance and inter-rater reliability
reviews - Arranges training and support to MHPs on provider portal
and technology
