Behavioral Health (Medicaid)
Paramount Behavioral Health Redesign Resource Center
Effective July 1st, 2018, all Medicaid Managed Care Plans, including Paramount Advantage, will be fully responsible for the entirety of Behavioral Health services used by our Paramount Advantage members. Paramount Advantage is currently responsible for managing our Medicaid population when a member accesses inpatient Behavioral Health services. Traditionally, outpatient care has been billed directly to the Ohio Department of Medicaid on a fee-for-service basis.
Along with improvements in care coordination and improved access to care for our members, Paramount is excited to team up with all Providers to assist with:
- Training Opportunities
Our Behavioral Health Department is developing a plan to meet the utilization and case management responsibilities required to ensure quality service delivery to our members.
What Is Behavioral Health Redesign?
The 2016/17 state budget continued the Kasich Administration’s commitment to modernize Ohio’s Medicaid program. At the center of this effort is a proposal to rebuild community behavioral health system capacity across the state. The legislation provided targeted investments to support initiatives such as:
- Developing new services for individuals with high intensity service and support needs
- Improving health outcomes through better care coordination
- Recoding of all Medicaid Behavioral Health services to achieve alignment with national coding standards.
Behavioral Health Redesign Resources
- Manuals, Rates & Resources
- Forums & Training Opportunities
- BH Redesign Newsletters
- Request for Claims Testing Form
- Pay, Deny, Pend – Claims Adjudication Explanation Document - The information contained within this document is subject to change and is updated periodically to reflect national HIPAA related changes and internal changes within Paramount’s claims processing system.
- Behavioral Health Initial Roster - Must be a Paramount contracted entity prior to submission. This roster will only be submitted one time. Any updates need to be provided on the Add/Term/Change roster.
- Behavioral Health Add/Term/Change Roster - Must be Paramount contracted entity prior to submission of this roster.
Rapid Response Team: PHC.BehavioralHealth@ProMedica.org
Our rapid response team is a multi-departmental team that can help coordinate and facilitate the testing process and answer provider/trading partner questions.
Currently, we have tested with Etactics, Practice Insight and TriZetto.
Provider Contracting: PHCProvider.Contracting@ProMedica.org
Toll Free: 1-855-522-9076
Toll Free Fax:1-855-448-4705