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Home Providers State Funded ServicesUtilization Management (UM) Resources

Providers' Page

Providers' Page

Utilization Management (UM) Resources

Clinical Decision Tools Used by CoastalCare Care Managers

Authorization Request Forms:

Click here for CoastalCare rates and fee schedules

Power Point Presention from UM Training

Resources on due process and EPSDT are located as specified below:

MCO DUE PROCESS: https://its.ncgovconnect.com/p39187305/
ESDT Policy Instructions: http://ncdhhs.gov/dma/epsdt/epsdtpolicyinstructions.pdf This document contains the listing of all Federal Medicaid services and the link to the federal definitions. The powerpoint was taken from this document.
EPSDT Slides: http://ncdhhs.gov/dma/epsdt/EPSDTTraining.pdf

Utilization Management Plan

Behavior Health Clinical Coverage Policies

Jail Diversion Service Definition

NCDHHS, Division of MH/DD/SAS Person-Centered Planning Instruction Manual

Clinical Practice Guidelines:

Anxiety Disorder Guidelines
- APA - Panic Disorder
- APA PTSD Guideline Watch 2010
Bipolar Disorders Guidelines
- TMAP Bipolar Guidelines
- VA Bipolar Guideline
Borderline PD Guidelines
- APA Update Borderline Personality Disorder Guidelines
Depression Guidelines
- TMAP Depression Guideline
- VA Depression Guideline
Eating Disorders Guidelines
- Eating Disorders 2010
Schizophrenia Guidelines
Child Mental Health
- Victims of Abuse Guidelines
  - Child Residential Care
  - Reactive Attachment Disorder
- ADHD Disorder Guidelines
  - Practice Parameter for the Assessment and Treatment of Children and Adolescents with ADHD
- Fetal Alcohol Syndrome Guidelines
  - Fetal Alcohol Syndrome
Developmental Disabilities
- Guidelines
Cultural Competence Guideline
- Guidelines
  - Cultural Competence Standards in Managed Care Mental Health Services
Disorders of Substance Abuse
- Guidelines
  - Disorders of Substance Abuse
- Recovery Guidelines
Medications & Names
- Guidelines
  - Commonly Prescribed Psychotropic Medications
Medical Necessity Criteria Resources