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Manuals & Reference Materials
Behavioral Health
Behavioral Health Provider Utilization Management Guidelines
- Out-of-state Provider Utilization Management Guidelines
- High Intensity Services Provider Utilization Management Guidelines
- Licensed Independent Clinical Social Workers Utilization Management Guidelines
- Clinic/Rehabilitation/TCM Utilization Management Guidelines
- Psychiatric Services Utilization Management Guidelines
- Psychological Services Utilization Management Guidelines
- FQHC & RHC Utilization Management Service Guidelines
Behavioral Health Provider Manuals and Instructions:
- Behavioral Health Provider Manual
- Instructions for Completing CareConnection® High Intensity (tiered)
- Instructions for Completing the CareConnection® for Private Practitioners (tiered)
- Instructions for completing CareConnection® for FQHC and RHC (tiered)
- Instructions for Completing CareConnection® for Clinic, Rehabilitation and TCM Providers (tiered)
- Instructions for Completing CareConnection® for Clinic, Rehabilitation and TCM Providers (numeric)
- WV Medicaid Staff Requirements for Covered Services – FQHC and RHC
- WV Medicaid Staff Requirements for Covered Services – LBHC
- WV Medicaid Staff Requirements for Covered Services – Private Practice
Behavioral Health Retrospective Review Tools:
Outpatient Consultation Tools
- Assertive Community Treatment
- Behavioral Health Counseling Professional
- Behavioral Health Counseling Professional Group
- Behavioral Health Counseling Supportive
- Behavioral Health Counseling Supportive Group
- Community Psychiatric Supportive Treatment
- Comprehensive Community Support
- Crisis Intervention
- Day Treatment
- Group Therapy - Focused
- Intensive Services
- LBHC Organizational Tool
- Mental Health Assess by Non-Physician
- Non-Methadone Medication Assisted Treatment
- Psychiatric Diagnostic Interview - Psychiatrist
- Psychiatric Diagnostic Interview - Psychologist
- Psychiatric Diagnostic Interview with Medical Evaluation
- Psychological Testing Tool
- Psychotherapy - Focused
- Residential Services
- Screening by Licensed Psychologist
- Short-Term Residential
- Skills Training and Development
- Targeted Case Management
- Therapeutic Behavioral Services Development
- Therapeutic Behavioral Services Implementation
- WV ACT Fidelity Factors
Private Practice Services Tools
- Biofeedback Psychotherapy
- Crisis Psychotherapy
- Developmental Testing Extended
- Developmental Testing Limited
- Diagnostic Interview Tool
- Family Psychotherapy
- Group Psychotherapy
- Individual Psychotherapy
- Med Eval Diagnostic Interview
- Mental Health Assessment by Non Physician
- Neurobehavioral Status Exam
- Medication Assisted Treatment Tool
- Neuropsychological Testing
- Neuropsychological Testing by Computer
- Private Practice Organizational Tool
- Psychological Testing
Medical Services:
CareConnection® System Information
- KEPRO Medical Provider Manual
- Searching for Determinations Cheat Sheet
- Appeals and Reconsideration Options
- Instructions for Copy for New Submission
- Instructions for Copy for Correction
- Frequently Used Numbers - Websites
- MCL - Master Code List
- Spring 2017 Molina Workshop Presentation
Home Health
Therapeutic Services - Physical & Occupational Therapy ~ Speech & Audiology ~ Cardiac & Pulmonary Rehabilitation ~ Chiropractic
DME - Durable Medical Equipment
- BMS Incontinence Guidelines
- Incontinence Flowchart
- DME Incontinence Supplies Update 2017
- DME Incontinence Supplies FAQ 2017
- DME T-Code Update May 2017
Vision
Imaging
Dental
Drug Code Changes
Speech and Audiology
Socially Necessary Services
Socially Necessary Services Provider Utilization Management Guidelines:
Socially Necessary Services Provider Manuals:
- Socially Necessary Provider Manual – Version 2.5
- Provider Manual – CareConnection Instructions & Definitions
- KEPRO CareConnection for Socially Necessary Service Web Manual
- SNS Provider Response File Manual
Socially Necessary Services Retrospective Review Tools:
- Adult Life Skills
- Agency Transportation
- Agency Transportation One
- Agency Transportation Two
- Agency Transportation Three
- Away from Supervision Support
- Case Management
- Chafee – Agency Transportation
- Chafee - Transitional Living Program
- Chafee - Transitional Living Program Phase 2: Part One
- Chafee - Transitional Living Program Phase 2: Part Two
- Connection Visit
- Family Crisis Response
- Home Study – In-state
- Homemaker Services
- Individual Review
- Individualized Parenting
- Intervention – Travel Time
- MDT Attendance
- Needs Assessment – Service Plan
- Private Transportation
- Private Transportation – Part One
- Private Transportation – Part Two
- Private Transportation – Part Three
- Public Transportation
- Public Transportation – Part Two
- Public Transportation – Part Three
- Respite
- Respite Crisis
- Respite Daily
- Respite Emergency
- Respite Situational or Behavioral
- Safety Services
- Supervised Visitation – Part One
- Supervised Visitation – Part Two
- Supervision
- Transportation Time
- Tutoring
