APS Healthcare Transition to OptumHealth – Timeline

September 13, 2011

OptumHealth Behavioral Solutions was selected by OHCA as the new SoonerCare Behavioral Health QIO vendor a few months ago. The OptumHealth contract begins October 1, 2011.  This contract covers all inpatient and outpatient SoonerCare behavioral health services.  To facilitate a smooth transition from APS to OptumHealth, timelines/deadlines have been established for APS Healthcare to begin the transition to OptumHealth, beginning September 25, 2011 at 11:59 PM.

The following timeline applies to All SoonerCare and Insure Oklahoma contracted behavioral health providers using the APS Healthcare authorization processes  for Outpatient; Inpatient; TFC; Private LBHPs, Psychologists and Psychiatrists; and Crisis Stabilization.

Outpatient PA requests:

• Outpatient Requests will be received by APS from providers (via EDI, APS CareConnection and fax) through Sunday, September 25, 2011 at 11:59 PM. 
• All requests (and any changes to existing requests) submitted to APS prior to September 25, 2011 at 11:59PM are to be processed by Friday, September 30, 2011 at 5 PM.  
• Any requests or changes that are not processed by APS by Friday, September 30, 2011 at 5PM will be transferred to OHCA to send to OptumHealth. 
• APS will not accept any new initial or extension requests, faxes (including Admit to Outpatient, Clinical Correction Responses, Courtesy Review Responses, Corrections, Modifications, MST, PACT, Notification of CDC Submission, Transfers, etc.) or files after September 25, 2011 at 11:59PM.
• CDCs will be received through Sunday, September 25, at 11:59 PM.

Inpatient PA requests:

• Initial requests (acute) will be received and processed through September 30, 2011 at 11: 59 PM. 
• Initial requests (RTC, TFC) will be received and processed through September 30, 2011 at 5 PM.
• Extension requests (acute) will be received and processed through September 30, 2011 at 5 PM. Extension requests (RTC, TFC) will be received through September 28, 2011 at 3 PM. Requests are to be processed by September 30, 2011 at 5 PM.

ALL historical APS records will be transferred to OHCA for use by OptumHealth. 

**OHCA, ODMHSAS, HP and OptumHealth will host a number of face to face and webbased provider trainings soon; watch for future postings on SoonerPro.** 

SoonerProHelpDesk@apshealthcare.com