Provider Portal

• Features

UMBH Provider Manual

• Provider Manual

QI Program Overview

• Provider Overview

Provider Newsletters

• Newsletter Archive

Improving Care and Service

• 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

• Medical Necessity Criteria

Cultural Competency

• UMBH Cultural Competence Overview
• Cultural Competency Plan Standards and Assessment

Utilization Management

• Utilization Management Notifications
• Standard Outpatient Treatment Forms
• UMBH Outpatient Authorization Guide

Member Rights and Responsibilities (Derechos y Responabilidades de los Afiliados)

• English version (html version)
• Spanish Version (html version)

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 Records
• Treatment Record Keeping Standards
• Treatment Record Review Guidelines
• Treatment Records Review Results 
• Behavioral Health Documentation Manual

Florida Medicaid Information

• Notice of Fiscal Agent Change
• Florida Medicaid
• Florida Medicaid Options

Provider Forms

• Forms

Community Links and Resources

• Resources

Educational Materials

• Strength-Based Models of Counseling and Resiliency

Continuity and Coordination

UMBH's values and expectations for continuity and coordination between the behavioral healthcare services delivery system and healthcare services delivery system and across the continuum of the behavioral healthcare services delivery system

Continuity and Coordination among all levels and practitioners of behavioral health care and primary care physicians (PCPs) is monitored and expected by UMBH. For inpatient admissions, coordination starts with the notification of the admission to the patient’s PCP and then at discharge by providing the PCP with the discharge summary. Should the discharge plan include a referral to Partial Hospital Program, IOP (intensive outpatient program), or outpatient counseling or treatment, the PCP needs to be informed by progress reports or summaries at each level of care by the practitioner(s) at that level of care. Continuity and coordination with the PCP is also essential if the enrollee accesses outpatient visits and does not require more intensive levels of behavioral healthcare. The frequency required for outpatient practitioner’s coordination is dependent on the diagnosis and treatment. Coordination with the PCP is essential when medication is prescribed and/or modified. Another area of continuity and coordination between behavioral health and PCPs is in reporting the results of psychiatric consultations performed at hospitals and nursing homes. The attending physician requesting the consult benefits from the timely receipt of the report of the psychiatric consultation and may need or wish to discuss the consult with the Psychiatrist.

Continuity and coordination across the continuum between all levels of behavioral healthcare is considered a reasonable standard of practice. If the inpatient attending is not the outpatient practitioner, notification at the point of admission, and again at discharge, is essential to maintain continuity of care. Coordination between outpatient practitioners with a shared client (split treatment) is essential in providing quality care. UMBH monitors and expects coordination between all levels of behavioral healthcare.

UMBH is aware of the need for a release of information in order to coordinate with both the PCP and other behavioral healthcare practitioners, and that some individuals are reluctant to sign the release. UMBH expects the reluctant individual to be educated by the behavioral healthcare practitioner regarding the importance of sharing information among those practitioners who are providing care and services.

UMBH's statement of analysis for 2006 and 2007 is available for your review.

 

• UMBH Exchange of Information Form
• UMBH Coordination of Care Guidelines