Prior authorization

We provide all utilization management services for your mental health needs. A prior authorization is required for the following mental health and substance use services:

  • Detox
  • Inpatient
  • Residential
  • Out-of-network outpatient

Request prior authorization or let us know of an urgent or emergent admission

Mental health education

Our Behavioral health provider education annual training is a series of slides for in-network behavioral health providers navigating care to individuals enrolled in a WellFirst Health benefit plan.

Additional resources:

Be prepared to provide the following information (not an inclusive list):

All services

  • Provider tax ID and address
  • Member name, birthdate and WellFirst Health ID #
  • Current diagnosis
  • CPT codes
  • Medications
  • Length of authorization
  • Clinical information supporting level of care being requested

Inpatient services

  • Admission date
  • Attending health care provider name
  • Provider contact name and phone number for concurrent review

You must notify us of any urgent/emergent inpatient mental health or detox admission within 24 hours of admission