Systems Overview
The Mental Hygiene Administration (MHA) is the agency within the Department of Health and Mental Hygiene responsible for the delivery of public mental health services. MHA operates seven inpatient psychiatric facilities and three residential treatment centers for children and adolescents, and funds community mental health services for Medicaid eligible individuals. In addition, MHA funds services to individuals who, because of the severity of their illness and their financial need, are qualified to receive state subsidized services. For the most part, these services are provided and funded through a fee-for-service system.
Management Team
MHA and the Core Service Agencies are assisted in their responsibility to manage the Public Mental Health Services by an administrative service organization (ASO), which operates under a contract with MHA. The ASO, ValueOptions, authorizes services, provides utilization management, management information, claims processing, and evaluation services.
Administrative Services Organization (ValueOptions)
ValueOptions, known as an Administrative Service Organization (ASO), assists Mental Hygiene Administration in the operations of the Public Mental Health System.
The ASO provides the following services:
- 24-hour access for clinically related calls
- Referring individuals to qualified service providers
- Preauthorization of non-emergency care
- Review of Authorization Plans to assist in determining whether an individual meets Medical Necessity Criteria and is part of the Public Mental Health System
- Conducting utilization reviews of services
- Collecting data
- Processing claims
- Remitting payments
- Assisting with the evaluation of the PMHS
General Description
Any practitioner who is authorized under the Health Occupations Article according to Maryland state law (COMAR) to provide mental health services, or a provider who is licensed under the Maryland Department of Health and Mental Hygiene Regulations, may be a provider in the PMHS.
Providers can access information regarding participation in the Public Mental Health System (PMHS) at Click Here
Participation in the Public Mental Health System Network (All Providers)
MAPS-MD does not credential or contract directly with PMHS providers. Providers are credentialed and contracted by the DHMH. The provider information in the DMHM system (MMISII) is downloaded to MAPS-MD weekly.
Click Here to go to ValueOptions® Website
To receive a State of Maryland Department of Health and Mental Hygiene Medical Care Program Provider Application, contact DHMH Provider Enrollment: 410-767-5340
On-line Provider Enrollment in the PMHS can be accessed at:
https://encrypt.emdhealthchoice.org/emedicaid
Note: The MA number must be a valid provider type and status. See Appendix M, State Approved Medicaid Provider Types for the PMHS.)
The provider should also contact ValueOptions® Customer Service, 1-800-888-1965, option 3, to request a “Welcome Packet.” The Packet contains important information about ValueOptions®, including authorization and claims payment processes, as well as instructions for enrolling in the on-line authorization system, ProviderConnect®.
This information can also be downloaded at:
http://maryland.valueoptions.com/providers.htm
Please note: The “Provider Confidentiality Agreement” included in the packet must be signed and returned before access to ValueOptions will be granted.