SANTA CLARA

Psychiatric Inpatient

Concurrent review and authorization for psychiatric inpatient services on behalf of Santa Clara
county Mental Health Plan (MHP)

About Our Program

California Inpatient Psychiatric
Hospital Concurrent Review

Effective January 8th, 2024, Acentra Health (formerly Kepro) has contracted with Santa Clara County to provide concurrent review services for psychiatric inpatient services.

  • Receives notification of admission and request for treatment authorization
  • Conducts concurrent clinical reviews to determine medical necessity using InterQual® and state criteria
  • Facilitates care coordination and discharge planning
  • Provides notices of denials and adjudications appeal requests
  • Prepares reporting and analysis of relevant providers and variables
  • Conducts internal quality assurance and inter-rater reliability reviews
  • Arranges training and support to Santa Clara County, hospitals and other providers on provider portal and technology