Behavioral Health Resources
Last Updated: Wednesday, December 20, 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.
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Behavioral Health Fax Number for Authorization Requests
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- 877-650-6112
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- Inpatient: 833-581-1866
- Outpatient: 833-581-1867
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For precertification or continued stay review requests for Behavioral Health treatment, please submit relevant clinical information via fax to the appropriate number above.
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
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- 800-258-9808
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- 844-946-6264
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- Outpatient Behavioral Health (BH) - ABA Requests: Service Authorization Request
- Applies to members of FEP and employees of PNC, Albertsons, and Centene.
- Additional Behavioral Health Forms are listed further down on this page.
Telemedicine and Virtual Visits
- Telemedicine and Virtual Visits for Behavioral Health Providers
This section contains information on Behavioral Health telehealth providers and procedures.
Provider Tools and Educational Resources
- Behavioral Health Toolkit for Primary Care Physicians
Resources to help provide behavioral health care for a range of diagnoses for Mental Health as well as Substance Use Disorder. Included are best practice recommendations, screening tools, and clinical practice guidelines.
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- axialHealthcare (now known as Wayspring)
Connects patients, providers and health plans with an end-to-end platform that covers the entire substance use spectrum. Highmark has collaborated with this program to offer a wide range of tools and resources to providers that aim to support the health and safety of patients on opioids and other controlled substances.
Behavioral Health Forms
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- 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.
- Opioid Treatment Certificate Update Form
- Use this form to add your Opioid Treatment Program Certificate to your provider file.
- An Opioid Treatment Certificate is required to receive payment when providing services at Opioid Treatment Programs (OTPs) to deliver Opioid Use Disorder (OUD) treatment services.
- Additional Behavioral Health forms may be found Here.
Credentialing
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Credentialing information for new providers can be found in the Credentialing section of the Provider Resource Center in the left-hand menu or by clicking Here. Scroll down on the page to find specific information for Behavorial Health providers. Additional information on Credentialing is available in Chapter 3 of the Highmark Provider Manual.
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Behavioral Health Practice Resources
The link above includes Behavioral Health specific sample treatment records, sample policies, and sample office forms and protocols intended for use to assist in office site evaluations and treatment record documentation compliance.
Related Links
Additional information on Behavioral Health, including provider responsibilities and guidelines, can be found in the Highmark Provider Manual.
