PBH believes that a strong alliance with our providers is the key to a successful managed care organization...more
Provider Standards of Practice
PBH realizes that its providers are the key to delivering service to members...more
PBH Network Provider Responsibilities
PacifiCare Behavioral Health (PBH) maintains programs that reduce and prevent risk and assure the safety of the member...more
Credentialing/Recredentialing for Independent Practitioners
PacifiCare Behavioral Health has developed and maintains a practitioner/provider network as an integral part of the delivery system for PBH members...more
Documentation Requirements
PacifiCare Behavioral Health has established the following goals for submission of clinical information by individual practitioners...more
Requirements for Submission to PBH
Individual providers are required to submit the following basic forms to PB...more
PBH and NCQA Requirements for Treatment Records and Clinical Documentation
PacifiCare Behavioral Health, Inc. (PBH) requires that all individual practitioners, group practices, facilities and chemical dependency programs must utilize the following standard...more
Treatment Record Audits
PBH conducts random treatment records audits to assure compliance with the required documentation standards...more
Specialized Service Procedures
Requests for psychological and/or neuro-psychological testing for patients, at any level of care, must meet PBH Medical Necessity criteria...more
