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7.4 NorthSTAR Program
7.4.1 Overview
NorthSTAR, in the Dallas SA, provides behavioral health services (mental health, chemical dependency, and substance abuse treatment) for Medicaid enrollees through a BHO. NorthSTAR also serves a clinically and financially eligible non-Medicaid population.
NorthSTAR is known as a behavioral health carve-out of the STAR Program in the Dallas SA. Medicaid provides access to physical health care while NorthSTAR provides mental health and chemical dependency (behavioral health) services.
NorthSTAR provides easier access to a comprehensive array of behavioral health services and providers. The program's goal is to provide clinically necessary behavioral health services to enrollees, through a network of qualified and credentialed providers.
In the NorthSTAR Program, ValueOptions is the sole BHO and is responsible for contracting with providers and maintaining a behavioral health-care provider delivery network. The BHO also:
• Offers education and support to the provider network.
•Performs utilization management through authorization of services, concurrent review, and special studies.
•Performs quality assurance monitoring and activities.
•Provides client services including education and outreach.
•Processes claims.
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