PO Box 016960 (LC-2940)
Miami, FL 33101
800-294-8642, ext. 4
305-243-7270, ext. 4
877-520-6254 TTY callers
UMBH Provider Manual
QI Program Overview
Improving Care and Service
Clinical Practice Guidelines
- Major Depressive Disorders practice guidelines
- ADHD practice guidelines
- Substance Use Disorders practice guidelines
- Panic Disorder practice guidelines
- Bipolar Disorders practice guidelines
- Suicidal Behaviors practice guidelines
- Schizophrenia practice guidelines
- Management of Children with Autism Spectrum Disorders practice guidelines
- Psychiatric Consultation practice guidlines
Continuity and Coordination
- Expectations for Exchanging Information
- UMBH Exchange of Information Form
- UMBH Coordination of Care Guidelines
Medical Necessity Criteria
- Utilization Management Notifications
- Standard Outpatient Treatment Forms
- UMBH Outpatient Authorization Guide
Member Rights and Responsibilities (Derechos y Responabilidades de los Afiliados)
Provider Privacy & Confidentiality
- Provider Confidentiality
- HIPAA General Rules
- UMBH Website Privacy Statement
- University of Miami Privacy Notice
Preventive Health Programs and Patient Safety Information
- ADHD Program
- MDD Program
- Targeted Care Management Program
- Post Partum Depression Program
- Patient Safety
- Treatment Records
- Treatment Record Keeping Standards
- Treatment Record Review Guidelines
- Treatment Records Review Results
- Behavioral Health Documentation Manual
Florida Medicaid Information
Community Links and Resources
UMBH Preventive Health Programs
UMBH is interested in helping you and your family stay healthy. We have developed an array of preventive health programs for common behavioral health conditions. These programs provide you with information that will help you stay healthy or recover more quickly from a behavioral health condition. Our preventive health programs cover the following topics:
ADHD is most frequently diagnosed in children though the condition can continue into adulthood. Children with ADHD frequently have difficulty paying attention, sitting still, or focusing on one task for a long period of time. Whenever UMBH finds out that a child has been diagnosed with ADHD, we automatically send our ADHD Help Guide to the child’s parents or guardians. The Help Guide contains information on ADHD. It also explains where to find more information, such as national organizations and Internet resources. For more information on the program, or to receive the Help Guide call Member Services at 800-294-8642. We strongly encourage you to take advantage of this program if you or a family member has symptoms of ADHD.
MDD is one of the most frequently seen mental health diagnosis in adults. About 6% of the general population may be depressed at any given time. Some people who are depressed have trouble sleeping, they lose weight, and they generally feel agitated and irritable. Others may sleep and eat too much and continuously feel worthless and guilty. Still others can function reasonably well at work and put on a "happy face" in front of others, while deep down they feel quite depressed and disinterested in life. There is no one way that people look and behave when they have major depression. Whenever UMBH becomes aware that an enrollee has been diagnosed with MDD, we automatically send the American Psychiatric Association’s MDD Patient and Family Guide to the enrollee. This Guide contains valuable information on MDD and its treatment, and provides resources to get more information on MDD. For more information on the program, or to receive a copy of the Guide, please call Member Services at 800-294-8642. We strongly encourage you to take advantage of this program if you or a family member has symptoms of MDD.
Some people who have been in the hospital for a mental illness have a difficult time staying out of the hospital. It can be difficult to complete day-to-day tasks such as taking medicine and keeping appointments. Our Targeted Care Management program is designed for these individuals. Special staff members at UMBH keep in touch with these individuals by telephone. We help remind them of appointments, assist them in keeping their appointments, and problem-solve concerning their day-to-day tasks. If you or a family member has been hospitalized for a mental illness and you think this program might be helpful, we encourage you to call UMBH Member Services Department at 1-800-294-8642 to see if the program is right for you.
Sometimes a new mom will get “down” or “blue” after having a baby. While this is not unusual, the baby-blues do not always go away by themselves. Sometimes the symptoms get worse instead of better. When this happens, the mom can develop what is called “post-partum depression.” We are working with our Health Plan partners to see that all of our members who become pregnant get information on the “baby blues” and on “post-partum depression.” The information includes the following topics:
- mood changes after childbirth
- what is post-partum depression?
- who gets post-partum depression and why?
- how long does post-partum depression last?
- different treatments for post-partum depression
If you have not received this information and you or a family member is pregnant or has recently had a baby, we encourage you to call UMBH Member Services Department at 1-800-294-8642. We will be happy to send you the information.