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.
Behavioral Health Code Changes (PDF)
Partnerships in Care (PiC) Program
Our Partnerships in Care (PiC) program uses data analytics and clinical reviews to enhance our partnership with you as the provider to maximize treatment successes. This approach is based on our philosophy that quality member care is achieved through purposeful collaboration with providers that serve our members receiving a multitude of behavioral health services.
If you are identified as a provider that could benefit from participation in the Partnerships in Care program through a data analysis, we will review members’ clinical documentation then collaborate with you to highlight areas of strengths and opportunities.
Provider Resources
- 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.