Behavioral Health Resources

Behavioral Health Resources

Last Updated: Thursday, September 12, 2024

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.

Behavioral Health Fax Number for Authorization Requests

  • wpa/ nepa
  • cpa/ sepa
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  • wv
  • 877-650-6112
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  • neny
  • Inpatient: 833-581-1866
  • Outpatient: 833-581-1867

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 Numbers

  • wpa/ nepa
  • cpa/ sepa
  • de
  • wv
  • 800-258-9808
  • wny
  • neny
  • 844-946-6264

Telemedicine and Virtual Visits

Provider Tools and Educational Resources

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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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  • de
  • wpa/ nepa
  • Applies to members of FEP and employees of PNC, Albertsons, and Centene.
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  • Additional Behavioral Health Forms are listed further down on this page.

Medication Assisted Treatment (MAT) Provider Form

  • Use this form to update your profile for Medication Assisted Treatment services in Highmark's networks.
  • 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.

Credentialing


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  • cpa/ sepa
  • de
  • wv

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.

Provider Manual

 

Authorization Resource: 

Behavioral Health Automated Care Management Authorization Submission Manual