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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

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Behavioral Health Management

BCBSGa Behavioral Health provides the coordination of mental health services for Blue Cross Blue Shield Healthcare Plan of Georgia members. It is also responsible for providing the inpatient utilization management services associated with our PPO and indemnity products. (Some group contracts may vary; please check the member's identification card for mental health services information.)  
With a network of trained, credentialed, and experienced providers covering the full spectrum of mental health services, BCBSGa behavioral health care specialists coordinate clinical considerations and collaborate with the patient, the patient's family, and the health care provider to establish the most appropriate, effective and cost-effective treatment plan. The BCBSGa network also includes hospital and treatment facilities statewide.  
Mental health services are accessible by calling 1-800-292-2879 on a 24-hour, 365 days a year basis. 
The Behavioral Health Medical Necessity Criteria document has been divided into several Clinical UM Guidelines and can be found at the link below under the Behavioral Health category:
Behavioral Health Clinical UM Guidelines

– CG-BEH-03 – Psychiatric Disorder Treatment
– CG-BEH-04 – Substance Abuse Treatment
– CG-BEH-05 – Eating Disorder Treatment
– CG-BEH-06 – Psychiatric Outpatient Treatment
– CG-BEH-07 – Psychological Testing
Other Medical Policies and Clinical UM Guidelines can be found at this link: Medical Policies and Clinical UM Guidelines  
Mental Health Forms
Individual Authorization Form - Psychotherapy Notes
Outpatient Treatment Plan Form
Post Discharge Ambulatory Follow-Up Appointment Authorization Form
Request for Authorization of Psychological Testing
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