Access our secured site
LoginLogin
Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

View requirements for Local Plan and BlueCard Out-of-Area members.

Search our online provider directory when you need a doctor, hospital, or other health care provider.

Mental Health Utilization Management

PW_AD048962
 
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 Clinical UM Guidelines can be accessed on the Clinical UM Guidelines main search page. Once the webpage displays, select the tab “By Category,” then the link BEH (Behavioral Health) to view electronic versions of Behavioral Health clinical UM guidelines. 
 

CG-BEH-01 Screening and Testing for Autism Spectrum Disorders and Rett Syndrome

CG-BEH-02 Adaptive Behavioral Treatment for Autism Spectrum Disorder

CG-BEH-03 Psychiatric Disorder Treatment

CG-BEH-04 Substance Abuse Treatment

CG-BEH-05 Eating Disorder Treatment

CG-BEH-07 Psychological Testing

CG-BEH-09 Assertive Community Treatment (ACT)

CG-BEH-10 Basic Skills Training/Social Skills Training

CG-BEH-11 Mental Health Support Services

CG-BEH-12 Psychosocial Rehabilitation Services

CG-BEH-13 Targeted Case Management (TCM)

CG-BEH-14 Intensive In-home Behavioral Health Services

 
The Behavioral Health Medical Policies can be accessed on the Medical Policies main search page. Once the webpage displays, select the tab “By Category,” then the link BEH (Behavioral Health) to view electronic versions of Behavioral Health medical policies. 
 

BEH.00001 Opioid Antagonists Under Heavy Sedation or General Anesthesia as a Technique of Opioid Detoxification

BEH.00002 Transcranial Magnetic Stimulation

BEH.00004 Activity Therapy for Autism Spectrum Disorders and Rett Syndrome

 
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
© 2016 BlueCross BlueShield of Georgia
Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.