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Provider Resources & Training

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Provider Training

ABH offers training to providers twice per year to review annual performance, updates from AHCA or Health Plans, and includes a clinical portion presented by the ABH Medical Director. Humana Healthy Horizons also offers training to educate providers about Fraud, Waste and Abuse as well as Cultural Competency.

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Level of care clinical criteria

Note: The materials provided are guidelines used by this plan to authorize, modify, or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract.

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ABH affirmative statement regarding Utilization Management (UM) decisions

  1.  UM decision making is based only on appropriateness of care and service and existence of coverage.
  2. Access Behavioral Health does not specifically reward practitioners or other individuals for issuing denials of coverage or care.
  3. Access Behavioral Health does not use financial incentives for UM decision makers to encourage decisions that result in underutilization.
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