Provider Monitoring

The Provider Monitoring process is designed for:

  • Entry into the provider network
  • The evaluation of service providers against quantitative and qualitative measures
  • For determining advanced placement status

The provider monitoring process is used to monitor both Medicaid and State-funded behavioral health services.

Review Information and Tools

Routine monitoring consists of a routine review and a post-payment review.

  • For Licensed Independent Professionals (LIPs) that includes the LIP Review Tool and the LIP Post-Payment Review Tool.
  • For provider agencies, the selection of tools is determined by the type services provided.
    • The Routine Monitoring Tool is used except when the agency provides Unlicensed AFL services, in which case the Unlicensed AFL Review Tool is used.
    • The specific post-payment review tool(s) to be used is based on the combination of services included in the sample.
    • For those services that DHSR-MHL surveys on an annual basis (i.e., residential services and opioid treatment services), only a post-payment review is done. 

Refer to the Instructions and Overview sections in each workbook for a detailed description of how the workbooks are organized and for more information on how all the component parts of the review fit together.

Frequently Asked Questions

Review Tools for Routine Monitoring of Licensed Independent Practitioners
Test Copy
Review Tool

Review Tools for Routine Monitoring of Provider Agencies
Test Copy
Review Tool

Provider Review Database
Test Database
Database

Contact

Email us questions or comments about the new tools or the provider monitoring process. Include the issue in the subject line.

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