PA Adjustment
Training
How to complete a PA Adjustment
• First you will need the PA number, the Member ID number,
and the start date for the PA you wish to be adjusted.
• Next you will need to click on the PA Adjustment Tab (located
under CDC Search in PICIS)
• Click Add New if you are requesting a PA to
be changed
• Searching for a PA Adjustment Request:
enter Member ID and PA number Click
search.
• After clicking Add NEW you will be to the PA
Adjustment Request Screen.
Insert your Contact
information, your name,
your email, your phone
(not the customers).
Insert the Recipient ID
and PA Number
PA Request Types
Three Types of Request Types
• Exceptional Case: A request for PA Adjustment may be
submitted when a client’s condition is severe enough to
require an intensity of outpatient services higher than Level
Four Medical Necessity Criteria, and all Medical Necessity
Criteria for Exceptional Case are met.
• Rehab for Ages 4-5:A request for PA Adjustment may be
submitted when a provider is seeing a child age 4 or 5 for
psychotherapy services, there is a defined need for behavioral
health rehabilitation services to compliment these more
intensive therapies, and all Medical Necessity Criteria for this
level of service are met.
Three Types of Request Types (cont.)
• Correct Authorization: A request for PA Adjustment may be
submitted when a provider finds any errors or discrepancies
on a PA (i.e., typographical error, wrong provider number,
wrong procedure group code, wrong Recipient ID number, and
some instant authorization edits) regardless of who made the
error.
• Be sure before doing a Correct Authorization that you have not
billed on the prior PA for the dates that you are needing
corrected, if so you will need to void those claims out.
Request Type 1: Exceptional Case (for agencies only)
• Exceptional Case is for clients above a Level 4 You will need to
include the following
• Documented support for the need for a 30-day period of increased
services beyond what is supported by a Level 4 authorization.
• A copy of the Behavioral Health Assessment
• Service Plan for the individual
• The Start Date is the date you want the PA to start
• To attach the behavioral health assessment and service plan
• Click browse, find the document, and then click attach
This is what it looks like
after you have attached a
document.
Request Type 2: Rehab for Ages 4-5 (for agencies only)
• Rehab for ages 4-5 is when you are need rehab for under the age of 6.
You will need to include the following
• Documented support for the need for rehabilitation services in the treatment
of the designated child
• Documented support that the child has the ability to benefit from curriculum
based education, including a description of the child’s development as it relates
to developmental expectations for age and stage particularly in the areas of
cognition and language
• Information regarding the curriculum to be used
• A copy of the Behavioral Health Assessment
• Service Plan for the individual
• To attach the behavioral health assessment and service plan
• Click browse, find the document, and then click attach
Request Type 3: Correct Authorization
This Request type is for any other adjustments that need to be
made to the PA
• Date correction
• Incorrect Provider Number
• Date Correction
• For the Start Date indicate the date you need the
PA to start and give a brief explanation.
• For all other corrections indicate the start date for
the PA and give a brief explanation of what
corrections needs to be done.
Contact Information
• PICIS HelpDesk
• 1-855-521-6444 or 405-521-6444
• gethelp@odmhsas.org
• http://ok.gov/odmhsas/