Behavioral health

Integrated healthcare

Wellpoint facilitates integrated physical and behavioral health services as a vital part of healthcare. Our mission is to address the physical and behavioral health care of members by offering a wide range of targeted interventions, education and enhanced access to care to ensure improved outcomes and quality of life for members.

We work collaboratively with hospitals, group practices, independent behavioral healthcare providers, community, government agencies, human service districts and other resources. This enables Wellpoint to successfully meet the needs of members with mental health and substance use disorders as well as those with intellectual and developmental disabilities.

Behavioral health training

Access more training

Documents

Texas MHTCM MHR Provider Training

Medicare Advantage BH ICR Training Presentation

Behavioral health forms

Access forms

Documents

Mental Health Targeted Case Management and Mental Health Rehabilitative Services Request Instructions: Chapter 15.2

Mental Health Targeted Case Management and Mental Health Rehabilitative Services Request Instructions: Chapter 15.4

Behavioral health prior authorization

Providers may request prior authorization for services by:

Using our preferred method online via Interactive Care Reviewer, which is accessed through Availity Essentials.

Dedicated behavioral health fax lines:

Faxing precertification requests to our dedicated behavioral health fax lines:

Inpatient services:

1-844-430-6805

Outpatient services:

1-844-442-8010

Behavioral Health Reimbursement Policies

Access our library of Behavioral Health reimbursement policies to guide you in claims submissions for behavioral health services that could be available in a member's benefit plan, addressing billable HCPCS or CPT® codes, and more.

If you cannot find the policy information you are searching for, please check our Reimbursement Policies page for additional guidance.

Note: Determination of coverage under a member's plan does not necessarily ensure reimbursement. Industry practices are constantly changing, and Wellpoint reserves the right to review and revise these policies periodically.

Behavioral Health Reimbursement Policy Definitions — Coming soon

Behavioral Health Reimbursement Policy Disclaimer — Coming soon