Utilization Management

Inpatient Pre-admission Review (IPAR)

Providers may request an inpatient pre-admission review by completing the GHS Inpatient Pre-admission Review Form (see link below) and faxing it to Utilization Management at (810) 496-4932 or by contacting Utilization Management by phone at (810) 496-4931. Reviews are completed 24 hours per day, 7 days per week.

• Inpatient Pre-admission Review (IPAR) Form rev. 6/7/2022
• Provider Reconsideration Form - PDF version rev. 8/11/2021
• Provider Reconsideration Form - Word version rev. 8/11/2021

UM-Related Documents

• FY'24 Utilization Management Plan
• FY'23 Utilization Management Plan
• General Fund Formulary
  A list of medications that GHS will fund for consumers who do not have prescription coverage and the med is prescribed by a physician/nurse practitioner working at a GHS program.
• Specialized Residential LOC Change Request Form
  This form is used to request a change in residential level of care designation. Please also refer to corresponding procedure.

UM Provider Manual

1. Utilization Management Provider Manual
2. Adults with Severe Mental Illness LOC Description
3. Adults with Developmental Disabilities LOC Descriptions
4. Children with SED and DD LOC Descriptions
5. GHS Benefit Plans - Adult MI-COD
6. GHS Benefit Plans - Adult DD
7. GHS Benefit Plans - Children SED-COD
8. GHS Benefit Plans - Children DD
9. Residential Placement Committee
10. CLF-Specialized Residential Placement Procedure for External Providers
11. Community Living Supports and Home Health Services Coordination
12. COFR Agreement Procedure
13. CRU Concurrent and Retrospective Review
14. Crisis Stabilization Continuing Stay Review
15. General Fund Medication Procedure
16. HSW Processes
17. Respite Services
18. State Inpatient Facility Admission Procedures
19. State Facility Discharge - Clinical Monitoring Guidelines
20. Provider Reconsideration Form
21. Service Authorization Packages

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