GUIDELINES & POLICIES
Optum follows national guidelines and policies to ensure the integrity of our network.
Best Practice Guidelines
Please view the Optum Best Practice Guidelines at our partner website for network providers only, Provider Express.
Network Provider Audit Tools
- Optum Idaho PHP Treatment Record Tool
- Optum Idaho BMC Record Tool 2023
- Audit Tool Change Index, effective Feb. 1, 2023
- Optum Idaho Peer Support Services Site Record Tool
- Optum Idaho Treatment Record Review Tool
- Optum Idaho Peer Support Services Site Audit Tool
- Optum Idaho Organizational Provider Tool
- Optum Idaho CCC Record Tool
- Optum Idaho Family Support Services Site Audit Tool
- Optum Idaho Family Support Services Record Review Tool
- Optum Idaho Skills Building Youth Record Tool
- Optum Idaho Targeted Care Coordination Tool
- Optum Idaho YES Program Review Tool
- Optum Idaho Respite Care Record Tool
- Optum Idaho Skills Building Adult Record Tool
- Optum Idaho Clinician Site Tool
- Optum Idaho Case Management Record Tool
- Optum Idaho BMC Record Tool
- Optum Idaho BMC Agency Tool
Network Provider Manual
Provider Manual
Provider Manual Change Index
Provider Manual Appendix (Does not reflect any allowances made for COVID service delivery.)
If you have any questions, please contact your Provider Relations Advocate.
Provider Clinical Questions: (855) 202-0983 | Primary Care Provider Psychiatric Consult press option 1
Level of Care Guidelines
Idaho Medicaid Supplemental Clinical Criteria Effective May 1, 2024
Idaho Medicaid Supplemental Clinical Criteria Effective July 1, 2023
Idaho Medicaid Supplemental Clinical Criteria Effective July 1, 2022
Idaho Medicaid Supplemental Clinical Criteria Effective March 1, 2022