Behavioral Health Services: Procedural Requirements

01. Enrollment. Providers will enroll in the managed care plan with the contractor and meet both the credentialing and quality assurance guidelines of the contractor. (7-1-26) 02. Authorization. The managed care contractor is responsible for authorization of covered behavioral health services that require PA. (7-1-26) 03. Complaints, Grievances, and Appeals. Complaints, grievances, and appeals are handled between the contractor and the Department in compliance with state and federal requirements. Participants will utilize the complaint, grievance, and appeal process required by the contractor prior to initiating an administrative appeal with the Department. (7-1-26)