Authorizations

CalMHSA has contracted with Kepro — now called Acentra Health — to conduct concurrent review and authorization for psychiatric inpatient hospital and psychiatric health facility (PHF) services on behalf of participating county mental health plans. For counties, delegating this process decreases administrative activity and cost, allowing clinical staff to dedicate time to direct care. Key components of the service include:

  • Notification of admissions and requests for treatment authorization from all California psychiatric inpatient and PHFs that use a uniform process
  • Concurrent clinical documentation reviews to ensure medical necessity is met
  • Care coordination and discharge planning
  • Notices of denials and adjudication of appeals
  • Robust utilization reports
  • Internal quality assurance and inter-rater reliability reviews
  • Training and ongoing support to mental health plans and hospital providers for Kepro‚Äôs electronic documentation review/submission portal

For more information about this service, please visit calmhsa.kepro.com or reach out to us at [email protected].