Behavioral Health
The WellCare Behavioral Health team is committed to quality service and partnership with our providers to improve our members' health and well-being.
Crisis Intervention
In the event of a crisis, members should contact our Behavioral Health Crisis Hotline: 1-855-661-6973.
Authorizations
WellCare uses Interqual™ criteria, a well-known and nationally accepted guideline for assessing level of care criteria. Obtaining appropriate authorizations are essential in providing needed care.
- 9000 Series Codes Authorization Requirements Provider Grid (PDF)
- ADHD Guide for Children and Adults (PDF)
- Behavioral Health Config FAQ (PDF)
- Coordination of Care Tips (PDF)
- Discharge Readiness Tips (PDF)
- Follow-Up After Emergency Department Visit for Substance Use (FUA) (PDF)
- Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) (PDF)
- Initiation and Engagement of Substance Use Disorder Treatment (IET) (PDF)
- Provider Manual (PDF)
- Provider Training (PDF)
- Quick Reference Guide (PDF)
- QRS Behavioral Health Measure Toolkit (PDF)
- Titration of Services Tips (PDF)
- Treatment Plan Development Tips (PDF)
- Wayspring: Supporting Members with Substance Use Disorder (PDF)
- Introduction (PDF)
- Severe Mental Illness (SMI) Principles of Practice (PDF)
- Physical Disease and Severe Mental Illness (SMI) (PDF)
- Barriers to the Recognition and Management of Physical Diseases in Adult Patients with Severe Mental Illness (PDF)
- Risk Factors and Screening Recommendations for Severe Mental Illness (SMI) (PDF)
- Monitoring Adult Patients with Severe Mental Illnesses: Recommended Frequency of Assessments (PDF)
- Metabolic and Cardiovascular Health Issues (PDF)
- QRS Behavioral Health Measure Toolkit (PDF)
- Hyperprolactinemia and Q-T Interval Prolongation in Serious Mental Illness (SMI) (PDF)
- Severe Mental Illness (SMI) and Special Populations: Women of Child-Bearing Age and Infants (PDF)
- Management Issues in Pregnancy and Lactation: Recommendations and Conclusions (PDF)
- Monitoring within the Severely Mentally Ill (SMI) Population1-7 Assessment Framework For Patients On Antipsychotic Medications (PDF)
- Applied Behavioral Analysis for Autism Spectrum Disorder (PDF)
- Detox and Substance Abuse Rehab Service Request (PDF)
- Discharge Summary (PDF)
- Electroconvulsive Therapy Services Request (PDF)
- Inpatient, Sub-Acute and CSU Service Request (PDF)
- Medication Reference Guide (PDF)
- PHP and IOP Service Request (PDF)
- Psychological and Neuropsychological Testing Service Request (PDF)
- Residential Treatment Service Request (PDF)
- Routine Outpatient Services Request (PDF)
- Targeted Case Management Service Request (PDF)
Helpful Information
Clinical Practice Guidelines (CPGs) are best-practice recommendations based on available clinical outcome and scientific evidence.
We provide ongoing treatment for behavioral health concerns that are critical in improving member’s health and well-being. WellCare offers Case and Disease Management programs developed to address depression and substance abuse, as well as other behavioral health conditions.