Substance Use Disorder

Trillium Community Health Plan follows American Society of Addiction Medicine (ASAM) criteria and other nationally recognized assessment and placement tools, such as InterQual, to guide evidence-based clinical decisions.

We use these tools to carefully review clinical documentation submitted by providers to support the review process and to ensure members receive the most appropriate care based on their strengths and presenting needs.

The information below is intended as a guide for preparing the required documentation for services requiring prior authorization. While not all the information will be relevant to all services, providers are encouraged to focus on those elements which are applicable to the service being requested.

ASAM Core Purpose

The ASAM criteria provide a structured, multidimensional assessment to match each individual to the least intensive, safe, and effective level of care, ensuring treatment is person-centered, needs-based, individualized, and responsive acorss continuum.

Resources

Free Centene Clinical Training Classes

"Clinical Documentation and The ASAM Criteria 3rd Ed: Connecting Documentation and The ASAM Criteria 3rd Edition for Trillium Providers"

Licensed behavioral health and substance use disorder professionals are invited to take a free virtual Centene Clinical Training class developed specifically for Trillium providers. The training covers how to connect clinical documentation and medical necessity with The ASAM Criteria 3rd edition for substance use disorder treatment.

Topics include treatment planning, progress notes, SMART goals, and NCQA’s treatment record guidelines, along with ASAM’s six assessment dimensions, stages of change, and levels of care. The emphasis is on documenting each member’s needs and treatment response to support appropriate care and authorization decisions.

Please register for the webinar date and time that best fits your schedule.

Note: Each individual learner will need to create an account in order to complete their registration for a course.

NEW! In addition to the webinars developed specifically for Trillium providers, Centene Clinical Training is adding "An Introduction to the ASAM Criteria 3rd Edition" trainings to the national provider training schedule.

"An Introduction to the ASAM Criteria 3rd Edition"

You can find all of our training opportunities on the Centene Clinical & Specialty Education website.

If you have any questions, please contact your Provider Engagement Account Manager.