Utilization Review


​​​​​​​​​The Utilization Review (UR) Committee is a subcommittee of the Sacramento County Quality Improvement Committee. This UR committee is comprised of representatives from Behavioral Health Services, Mental Health County and Contracted Providers and Division Advocate Liaisons representing clients, families and youth. The UR Committee is responsible for Sacramento County’s mental health quality improvement process and ensuring that the mental health plan is on track to reach quality benchmarks described in the Quality Assessment and Performance Improvement (QAPI) Work Plan. This includes reviewing and planning for compliance to regulations and the Department of Health Care Services (DHCS) Protocol items; following through with the DHCS triennial plan of correction; preparing for audits; discussing quality improvement trends found in audits; updating utilization review tools, internal utilization review minutes and documentation policies and procedures; discussing updates to documentation trainings; creating helpful quality improvement resource documents and overseeing the adequacy and appropriateness of chart documentation.

Utilization Review Tools for Adult and Child Mental Health Charts
Electronic Utilization Review General Tool
Therapeutic Behavioral Services (TBS) EUR Tool

Mental Health Urgent Care Clinic Utilization Review Tool
Mental Health Urgent Care Clinic E​UR Tool​​

Utilization Review Addendum Tools
Utilization Tool Addendum - Day Treatment Intensive (DTI) & Day Rehabilitation (DR)​
MHSA Programs Addendum Tool (This Addendum Tool may also be used by Providers who utilize support service codes and flexible funding codes) 

Utilization Review Documents and Resources​
Internal Utilization Review Minutes Template (Right click and Save As)​​​​​​
McFloop Form
MHSA Program McFloop Form
EUR Supplemental Worksheet (Recoupment shall be focused on fraud, waste, and abuse).​
Helpful Lists and Screens in SmartCare

 

For Policies & Procedures (P & P) related to Utilization Review, please see our P & P webpage or send an email to QMInformation@saccounty.gov. ​






 
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