Behavioral health providers

Behavioral health is critical to a patient’s overall health. Thank you for the care and support you provide to your patients—our members.

Our behavioral health team provides support and assistance for members with substance use disorder or mental health needs. Whether you're an individual clinician, primary care provider or facility, we're dedicated to being a good partner.

Providing inclusive care

We are working to close health equity gaps to ensure simpler, better, more affordable health care for those we serve—from all backgrounds and walks of life. Good health is influenced by the environments where your patients live, learn, work, play, worship and age. These factors—known as social determinants of health (SDoH)—affect health outcomes and may lead to medication non-compliance, hospital readmissions, unnecessary emergency department visits and other medical issues.

We encourage you to document SDoH ICD-10-CM Z codes during patient encounters. These supplemental diagnosis codes help us understand barriers to care and social risk factors, as well as helping us identify opportunities to support our members, such as through transportation or in-home care or by connecting members to food banks and other community resources.

Review our Cultural Competency resources to develop and improve your cultural competency and health literacy.

Toolkit for PCPs

Our behavioral health toolkit includes resources specific to 12 diagnoses and challenges to support primary care providers (PCPs).

Access the toolkit

Facilities

View information specific to behavioral health facilities, including pre-authorization requirements and care management services for members.

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Library & forms

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Claims & reimbursement

New in 2023: Learn about our Incident to Services (Administrative #148) reimbursement policy and more in our Reimbursement Policy Manual.

Provider reimbursement schedules and other pricing documents are available in Availity Essentials: Payer Spaces>Resources. You’ll also find eligibility, benefits and claims-related information for most members.

  • All claims must be submitted electronically.
  • All claims payments are made via electronic funds transfer (EFT).
  • Learn how to identify members, easily submit claims and receive payment for services and supplies.

Appeals

If you have had a pre-authorization request denied, consult the denial letter for any appeal process specific to the member's plan.

Submit appeals in Availity Essentials.

Learn more about pricing disputes and appeals.

Contact us

Our Self-Service Tool is available 24/7 with answers to frequently asked questions. Availity Essentials has eligibility, benefits and claims-related information for most members. For other questions, call our Provider Contact Center.

Clinical Intake Operations

  • Phone: 1 (800) 780-7881
  • Fax: 1 (888) 496-1540

Join our Provider Advisory Council.