Behavioral Health Information

APS Healthcare has the contract with the State of Maine’s Department of Health and Human Services to provide a Behavioral Health Utilization Management System for services currently purchased through the State’s Office of Maine Care Services and administered by the Adult Mental Health Services, Children’s Behavioral Health Services, and the Office of Substance Abuse. APS Healthcare encourages respect, collaboration, and partnership among all entities serving the Members. They believe that the best method to achieving input from Providers, Members and Families, Advocates, and other entities is to involve key representatives of each of these groups in every step of the process. APS Healthcare’s collaborative model will be an integrated one that welcomes inclusion by all interested stakeholders. APS has significant experience in developing innovative, collaborative models of utilization management, care management, Provider Relations and quality improvement that emphasize community partnership, training, technical assistance. They have been highly successful in improving collaboration and coordination among providers that increases access and improves clinical outcomes while controlling costs. This successful integrated, collaborative approach will be utilized in Maine. APS Healthcare will provide the following services:

  • Eligibility Verification

  • Utilization Management Services including: Prior Authorization, Utilization Review, and Retrospective Review

  • Provider Relations

  • Member Services Capability

  • Quality Management (QM) and Improvement  

  • Appeals and Grievances

Each resident, prior to admission into a nursing facility, is required to have a completed PASRR-MI, which stands for “PreAdmission, Screening and Resident Review for Mental Illness.” To gain further information on the PASRR process, please visit the APS website.

To obtain PASRR documents, please click here.