Effective 2005, ValueOptions will deploy a new internal clinical system application: CareConnect. CareConnect is designed to streamline and standardize our authorization process as well as enhance data collection for outcomes measurement. The outcomes measurement will be shared with you in the future.

As a result, you will find new Outpatient and Inpatient Registration Forms. Begin using the new forms immediately as the current Outpatient Treatment Report (OTR), Medication Management, and Inpatient Treatment Report (ITR) forms are obsolete. For more information and to access the new forms click on the appropriate links below. The new forms are also available on the Forms section of our website.

Note:
There are a few audiences to which the new process does not apply. Please read the Provider Notifications for more information.

Frequently Asked Questions (PDF)

New Streamlined Clinical Document Submission Fax Number and Address Information (PDF)

Outpatient Authorization Request Forms

Provider Notification (PDF)

Outpatient Registration Form (ORF1) (PDF) & (Instructions) (PDF)
Use for routine outpatient care (excludes psychological testing requests).

Outpatient Review Form (ORF2) (PDF) & (Instructions) (PDF)
A companion form to the ORF1, only use the ORF2 if requested by a ValueOptions’ Clinical Care Manager.

Medication Management Registration Form (PDF)
Only use this form if you are a ValueOptions’ provider credentialed to offer medication management services.

Inpatient and Higher Levels of Care Authorization Request Forms

Provider Notification (PDF)

Inpatient Treatment Report (PDF) & (Instructions) (PDF)
Use for authorization requests for inpatient and all alternative/higher levels of care.