Mental health

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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

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

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:

Behavioral 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