The Provider Manual contains information that is critical for our providers such as authorization processes, reporting and documenting serious incidents, client rights and contract compliance.

• Click here to download the Provider Manual.

If you have questions about a service that you have been authorized to provide or would like more information about requirements for different services, see our service definitions below to learn more.

IDD

SAMSO Services

• Transitional Housing Case Management

CFS Services

Integral Care’s Utilization Management (UM) department authorizes many provider services. The following forms are related to authorizations and are helpful reference materials.

Authorization Forms

To obtain a service authorization, providers must submit the required forms to UM.

• Download the Eligibility and Consent Form (ECF).
• Download the Authorization Request Form (ARF) for Treatment Services
• Download the Authorization Request Form (ARF) for Ancillary Services.
• Download a Referral Form.

Submitting Forms to Integral Care

Because authorization forms may contain client signatures or identifying information about the client, the forms must be submitted to Integral Care through our secure FTP site.

Visit the FTP site and upload your authorization forms.

FTP site

Helpful Reference Materials

• A Clinical Guide to Completing Authorization Request Forms (ARFs)
• Transitional Housing Reference Document

For UM appeals or to contact a UM Resource Allocator, call 512-440-4044. You can also reach the UM Department at UM@integralcare.org. If you have questions about services that are authorized outside of UM, such as those authorized by service coordinators or care coordinators, please contact us at providers@integralcare.org.

REQUEST FOR APPLICATIONS
Applications for contract renewals are accepted throughout the year from organizations and individual service providers. There are currently two Requests for Applications that are open.

• Application for Organizations
• Application for Individual Providers

More information about the RFA including requirements, instructions, services and rates.

Providers are also required to complete the following credentialing form(s).  Organizations in need of credentialing assistance for new providers should use these forms.

• Form: Verification Checklist for Organization Group Member Providers
• Form: Background Check Form for Organization Group Member Providers

Below are copies of our various invoice forms.

• Click here to access the PASRR Provider Invoice Form.
• Click here to access the ECI Provider Invoice Form.
• Click here to access the IDD Provider Invoice Form.
• Click here to access the YES Waiver Provider Invoice Form.
• Click here to access the other (Children’s Partnership, Children’s Continuum, YAFAC) Provider Invoice Form.

Do you need to file an incident report related to a critical incident that occurred with an Integral Care client or while an Integral Care client was in your care?

• Click here to be directed to Integral Care’s Incident Reporting System.

Examples of incidents include but are not limited to:

• Client or employee injuries and accidents
• Behavior incidents
• 911 EMS Mental Health Officer or Police involvement
• Medication errors
• Property damages
• Client rights violations
• Death

If you have questions about incident reports, please contact Melody.Moscal@IntegralCare.org or 512-440-4049.

Click here to request provider training or to request assistance with your existing Relias account:

Provider Training

Integral Care values you as a provider. The Ombudsman offers Provider Liaison functions to our network of providers including managing appeals, complaints and concerns, answering questions and facilitating mediation.

Appeals

Providers have 15 calendar days from a denial to request an appeal.

• You may request an appeal by sending an email request to: Phyllis.Wolf@integralcare.org.
• Please include the reason why you disagree with the denial and any supporting documentation.
• If any client-identifying information is included, it needs to be sent encrypted.
• Please see the Provider Manual for more information.
• Appeals-related to Utilization Management/Resource Allocation is a separate process through Utilization Management.

The Ombudsman makes every effort to respond to complaints in a timely manner. The Ombudsman will keep providers informed of the process and provide additional details as needed.

Didn’t find the information you were looking for or still have questions about provider services? Contact us at providers@integralcare.org