Behavioral Health Resources

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 the 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:

• 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 Number: 844-946-6264

• Outpatient Behavioral Health (BH) - ABA Requests: Service Authorization Request 
• 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.

Behavioral Health Forms

• Discharge Summary Fax Template
• Outpatient Behavioral Health (BH) - ABA Requests: Service Authorization Request 
• 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

• 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.

Provider Responsibilities and Guidelines

This section of the Highmark Provider Manual outlines Behavioral Health provider responsibilities and guidelines. Other sections of Chapter 4 cover PCPs, other specialists, ancillary providers and outpatient radiology and laboratory.