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Behavioral Health UR Implementation

Posted May 17, 2023

Healthfirst's new, trigger-based approach to utilization review (UR) for certain acute mental health services.

In response to a requirement by the New York State Office of Mental Health (OMH), Healthfirst has implemented a new, trigger-based approach to utilization review (UR) for certain acute mental health services (MH) for all of our health plans, except for Medicare Advantage plans. Our new, trigger-based UR approach went into effect Feb. 6, 2023. Our Medicare line of business is excluded. Click here for more detail...