Last Updated: Monday, June 19, 2023
Highmark strives to actively help providers identify members who can benefit from fully accessing their mental health/substance use disorder benefits in a timely manner.
The most critical obstacles that Highmark focuses on are getting a member's attention, helping them to overcome the cultural and social barriers represented by stigma, and seeking care and treatment for mental health/substance use disorder conditions early in the course of the illness. Delays and care not received can significantly impact the member’s quality of life and experiences when treating other health issues.
Highmark has added several specialty providers to further augment our existing network to better serve our members. This includes new and innovative treatment delivery that makes the best use of telemedicine channels (synchronous and asynchronous), digital tools, multi-disciplinary approaches, health information presentation/delivery, and continuous contact with the member’s treatment.
The provider resources included below are meant to help you link the members you see to appropriate care in the most streamlined way possible to secure the best use of available benefits.
For precertification or continued stay review requests for Behavioral Health treatment, please submit relevant clinical information via fax to 877-650-6112.
Submission of the complete medical record may slow down the process and is not an efficient way to communicate the clinical need for an admission or continued stay review.
Please fax the relevant clinical information to support the treatment request using your own fax format as needed.
Behavioral Health Phone Number: 800-258-9808
Outpatient Behavioral Health (BH) - ABA Requests: Service Authorization Request
Applies to members of FEP and employees of PNC, Albertsons, and Centene.
Medication Assisted Treatment (MAT) Provider Form
Use this form to update your profile for Medication Assisted Treatment services in Highmark's networks.
Related Links
This section of the Highmark Provider Manual outlines Behavioral Health provider responsibilities and guidelines. Other sections of Chapter 4 cover PCPs, other specialists, ancillary providers and outpatient radiology and laboratory.
Behavioral Health Automated Care Management Authorization Submission Manual