Behavioral Health

Credentialing submissions
You should submit all credentialing requests online to Optum Behavioral Health for all Rocky Mountain Health Plans behavioral health care professionals through the Optum Provider Express portal.

Credentialing
What you need to do

• Be responsive to any re-credentialing requests from Optum Behavioral Health on behalf of Rocky Mountain Health Plans
• Initiate credentialing online with Optum Behavioral Health. You can find the credentialing process instructions at Our Network 

Update Provider and Practice Demographics

Submit demographic requests online for all Rocky Mountain Health Plans behavioral health care professionals through the Optum Provider Express portal and select My Practice Info located on the right side of the page within Transactions. Allow up to 5 business days for your request to be completed.

Use the Add / Update / Inactivate Tax ID to change your tax identification information or add another practice location with a different tax ID number (TIN).

For more information or to get a User ID, visit the First-time User link.

• RAE Provider Manual
• RAE Reference Guide
• Community Plan of Colorado Patient Choice Form
• Community Plan Rocky Mountain Health Plan Colorado Behavioral Health Consent to Release Records Including SUD Treatment Form
• Colorado Medicaid sterilization consent form (med-178)

RAE overview
Rocky Mountain Health Plans is the Regional Accountable Entity, or RAE, for Region 1 of the Health First Colorado Accountable Care Collaborative. Rocky Mountain Health Plans is responsible for connecting Health First Colorado Members with both primary care and behavioral health services for Region 1, which includes Western Colorado and Larimer County.

The RAE for region 1 includes:

• The primary care medical provider network and care coordination services
• Managing covered services under the Medicaid Capitated Behavioral Health Benefit
• The Western Colorado payment reform initiative known as Rocky Mountain Health Plans PRIME
• Additional services to support whole person care, including activities to address social determinants of health

You must be revalidated and enrolled with Health First Colorado to participate in Rocky Mountain Health Plans RAE network.

Learn more
For more information, visit the Department of Health Care Policy & Financing page. For questions, email raesupport@uhc.com.

The role of RAE

• Develop a cohesive health neighborhood where care across disparate providers is coordinated and collaborative
• Establish and improve referral processes, including use of care compacts
• Encourage collaborations and strategies with a wide range of community partners to address social determinants of health
• Develop a population health management plan to prevent the onset of health conditions and lessen the impact of health conditions on member’s lives
• Utilize evidence-based practices and promising local initiatives, including those addressing social determinants of health

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefits
EPSDT is an important benefit for Health First Colorado Members. Those eligible for this benefit include:

• Health First Colorado children from birth through age 20
• Adults who are pregnant, including Rocky Mountain Health Plans PRIME members

Contract and engage with primary care medical providers

• Develop and maintain a network of participating primary care medical providers (PCMPs)
• Provide training and support to primary care practices
• Reimburse PCMPs through a value-based payment model

Contract and engage with behavioral health care professionals

• Develop and maintain a credentialed and contracted statewide network of behavioral health care professionals
• Provide utilization management of covered behavioral health services
• Reimburse behavioral health providers for services covered under the capitated behavioral health benefit
• Provide training and support to behavioral health care professionals

 To learn more about RAE, review the Rocky Mountain Health Plans Behavioral Health Guide.

Suicide hotline
Skilled, trained counselors are available to answer calls 24 hours a day, 7 days a week, at 988 (or 800-273-8255) or on the Lifeline Chat:

Crisis help
Crisis help is available at no cost and is available 24 hours a day. Call 1-844-493-TALK (8255), or text “TALK” to 38255. 

Claims processing

• For dates of service after Jan. 1, 2023, UnitedHealthcare will process all claims for Rocky Mountain Health Plans members
• For dates of service before Jan. 1, 2023, Rocky Mountain Health Plans will process claims for members

Claims submissions
Use the electronic data interchange (EDI) payer ID 87726 for all plan types. Submit claims to the appropriate mailing address after Jan.1, 2023:

UnitedHealthcare Individual Exchange claim
PO Box 5290
Kingston, NY 12402-5290

UnitedHealthcare^® Medicare Advantage claim
PO Box 31362
Salt Lake City, UT 84131-0362

UnitedHealthcare D-SNP, UnitedHealthcare Community Plans, UnitedHealthcare Regional Accountable Entities (RAE), UnitedHealthcare PRIME, Children’s Health Insurance Plans
PO Box 5260
Kingston, NY 12402-5260

Claims payments

• For claims with dates of service prior to Jan.1, 2023, you’ll receive payment through Optum Vpay
• For claims with dates of service after Jan. 1, 2023, you’ll receive payments through Optum Pay

Because of claims processing timelines, you may receive payments from both systems until all claims with dates of service before Jan. 1, 2023, are processed.

Learn more about Optum Pay.

Prior authorizations
Submit prior authorizations in one of the following ways:

• Email: rmhpbhvm@uhc.com
• Call: 855-886-2832
  
• Fax: 970-257-3986

Learn more
View the uniform service coding standards to get more information about prior authorizations for behavioral health services.

Questions
If you have questions, contact the customer service department at 877-842-3210 or contact your UnitedHealthcare Provider Relations representative.  Thank you.