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Provider Checklists

Prior to submitting a Service Authorization, we recommend reviewing our Provider Checklists. These checklists were created to ensure all medical necessity, admission, continued stay, and discharge criteria are met for the specific Service Type and/or Procedure Code being submitted.

ACT ARTS 2.1
ARTS 2.5 ARTS 3.7
ARTS 4.0 ARTS Family Support Partners-updated
ARTS Peer Support Services-Individual ASAM 3.3
ASAM 3.5 BH Service Authorization Registration Grid
Mental Health Family Support Partners Mental Health Peer Support Services-Individual
Mental Health Skill-building Services (MHSS) MH IOP
MH PHP Mobile Crisis
MST PSR
RCSU Specialized Care Long Stay Hospital
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