Mental health

Notification

Notification is required within 24 hours of admission for urgent/emergent acute inpatient or detoxification services and may be reviewed for continued stay.

Prior authorization

Prior authorization is required for the following non-urgent/non-emergent mental health services:

Elective inpatient
Residential
Out-of-network outpatient

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

Submit information through the Provider Portal (if you have access)
Fax request to 608-252-0843 using the behavioral health prior authorization form.
Call Member Services at 1-866-514-4194.

Mental health education

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

Additional resources:

Mental health HEDIS measures

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.