Sec. 10.09.59.08. Authorization Requirements

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A. The ASO shall establish a process, through a utilization review system, for authorization of specialty mental health services.

B. The ASO shall authorize services that are:

(1) Medically necessary;

(2) Of a type, frequency, and duration that are consistent with expected results and cost-effective; and

(3) Delivered in a manner consistent with this chapter.

C. Preauthorization is not required before a provider renders services in an emergency department.

D. Except as provided in Regulation .08C of this chapter, no payment shall be rendered for services that have not been authorized.

                    
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