Behavioral Health Overview
Asuris Behavioral Health provides online tools for efficient communication from your office to ours.
Mental Health and Chemical Dependency Pre-authorization
Please reference the Pre-authorization section for Mental Health and Chemical Dependency pre-authorization information.
Clinical Practice Guidelines
The Mental Health and Chemical Dependency Treatment practice guidelines describe generally accepted practices and were developed by nationally recognized organizations. Practice Guidelines are available at http://blue.regence.com/trgmedpol/clinical/practice-guidelines/index.html
Behavioral Health Clinical Review Criteria
Asuris utilizes Milliman Care Guidelines, Asuris Medical Policy and CMS Policy for medical necessity determinations. Asuris utilizes the patient placement criteria from the American Society of Addiction Medicine (ASAM) for substance abuse medical necessity determinations.
The Milliman Behavioral Health Guidelines are evidence-based criteria that are widely used within the health care industry. The criteria are available for purchase through Milliman or you may request a copy of the guidelines for a specific service by calling 1 (800) 780-7881.
| Behavioral
Health Pre-authorization Forms |
| Form |
Description |
Instructions |
Behavioral Health Treatment Plan Request
|
This form is for members who require an authorization for behavioral health outpatient treatment, including chemical dependency.
Submit this form to Asuris for authorization of continued services. |
Please call Asuris Behavioral Health Customer Service at 1 (800) 780-7881 for any authorization questions.
Complete the Treatment plan request form securely online or you may download the form (PDF) and submit by fax to Asuris Behavioral Health 1 (888) 496-1540. |
Revised December 2011
|
