OUTPATIENT SERVICES (MENTAL HEALTH AND D&A)
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Registration
Each provider may see a new patient for up to forty (40) units prior to the submission of the Outpatient Registration Form (ORF1) under the pass through visits. After the initial pass through visits, the provider must submit an Outpatient Registration Form (ORF1). A clinic must coordinate the initial forty (40) units amongst all of the professionals who are treating the member. The ORF1 must be submitted 10 business days prior to the requested begin date on the form.  Concurrent authorization visits and timeframes will be based on Medical Necessity Criteria.

Concurrent Review
Prior to the twentieth session, the provider must submit a completed Outpatient Registration Form (ORF1 and/or Medication Management Registration (Meds Only) form to the Service Center.

Providers should submit registration forms at least 10 business days prior to the date of the twentieth session.  The member’s eligibility will then be confirmed and the ORF1 will be reviewed for medical necessity by our Service Center staff.  An authorization letter will be sent to the provider detailing the number of sessions granted, the service class authorized, and the timeframe of the authorization period.  The provider must submit another Registration Form (ORF1 and/or Medication Management Registration form at least 10 business days before the authorization expiration date if  further sessions and/or time are needed.

If an  Registration Form (ORF1 and/or Medication Management Registration form are received after the twentieth visit, or after the last authorized visit on a continued stay review, then care will only be authorized as of the date the  Registration Form (ORF1 and/or Medication Management Registration form was received.

Registration Form (ORF1 and/or Medication Management Registration forms may either be faxed to 724-744-6329 or mailed to:

VBH-PA Service Center
520 Pleasant Valley Road
Trafford, PA  15085
Attn:  ORF1 Screeners

Please contact VBH-PA for assistance in completing and submitting Registration Form ORF1 and/or Medication Management Registration forms (Toll Free Provider Line 877-615-8503).

Note: Forms are available to download for the services above at:
http://www.vbh-pa.com/provider/forms.htm