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The MHR program has established a prior authorization system to manage services.
The Service Access and Authorization unit partners with members and providers
to ensure services requested in the intervention plan match the needs of the
member. Services provided without prior authorization will not be reimbursed.
Following the interim authorization period, ongoing services may be approved for
up to 90 days. Requests for reauthorization should be submitted 14 days prior
to the expiration of the current authorization to avoid lapses in services and
to assure timely processing of requests.
Providers and members will receive written notifications of approved, partially
denied, and/or denied requests. A request for additional information will be
sent to providers if required information is missing (such as Social Security
number, address, signature page, etc.).
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Phase One: Screening for Eligibility |
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Phase Two: Determining Eligibility and
Developing the Interim ISRP |
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Phase Three: Developing the Initial ISRP |
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Phase Four: Conducting the Reassessment
and Updating the ISRP |
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Request for Revisions |
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Access to Emergency Services |
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Recipient Transfer (recipient voluntarily chooses a
new provider) |
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Recipient Readmission |
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Reconsideration |
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Voluntary Provider Closure |
Authorization is issued for a specific member for a specific period of time. The
decision to authorize is based on, but not limited to, the following:
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Progress member/families are making toward
accomplishing goals |
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Effectiveness of the service plan |
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The type and intensity of services |
For more information about the prior authorization process, refer to the MHR
manual Chapter 31 Section 31.2.
Click
here to view the MHR manual
Go to Prior Authorization Documents
Go to Utopia and MHRSIS Data Systems
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window will open. Follow the instructions.
Microsoft Word 
PowerPoint Viewer
Adobe Acrobat Reader
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Revised Authorization Process (10-18-2010)
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