Behavioral Health Services - Utilization Management

North Sound BH-ASO maintains a behavioral health provider network in the North Sound Regional Service Area (RSA) for Crisis and non-Crisis behavioral services. 

North Sound BH-ASO contracts and provides funding for the following services for individuals in North Sound RSA:   

  • Behavioral Health crisis services and involuntary treatment evaluations
  • Involuntary detentions to psychiatric and secure withdrawal management facilities for non-Medicaid individuals;
  • Treatment and monitoring of non-Medicaid individuals who have active Less Restrictive Alternative (LRA) court orders to include Assisted Outpatient Treatment and Conditional Release orders; and
  • Non-crisis behavioral health services for non-Medicaid individuals who are at or below the 220% Federal Poverty Level utilizing General Fund State (GFS) or Federal Block Grants (FBG) within available resources.

Individuals not eligible for Apple Health Medicaid, may qualify for General Funds – State (GFS) or Federal Block Grant funding.   North Sound BH-ASO’s Contracted providers will assess ASO funding eligibility for Mental Health or Substance Abuse Disorder outpatient and residential treatment services.

Individuals seeking mental health or substance abuse treatment may contact North Sound BH-ASO contracted providers directly or contact our customer service line 888.684.3555 for more information.

Authorization for Services – Utilization Management
  • Crisis Services, to include Involuntary Treatment evaluations by a Designated Crisis Responder (DCR), does not require services authorization – every individual within the North Sound RSA can access crisis services.
  • Non-Crisis Behavioral health services require authorization from North Sound BH-ASO. Provider questions can be direct to Customer Services (360) 416-7013.   
  • Involuntary Treatment Act (ITA) Certifications – Providers are required to request certification for payment for ITA services for ASO eligible individuals by contacting (360) 419-6562.

Utilization Management Forms

  • Authorization for voluntary psychiatric Inpatient services for non-Medicaid individuals that meet eligibility criteria for General State funding, requires prior authorization or approval.

Policies and Procedures

North Sound BH-ASO’s Utilization Management Policies and Procedures can be accessed by visiting our For Providers Page – Policies & Procedures, Section 1500. 

 

Suspect Fraud?

800.684.3555

Anonymously report suspected fraud, waste, or abuse to the North Sound BH-ASO Compliance Officer by using the Compliance Hotline.

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Dissatisfied with service?

888.336.6164

or visit the Ombuds website for assistance in filing a complaint or appealing a denial of service.

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