Mental health prior authorization
Utilization Management services
Prevea360 Health Plan provides all Utilization Management services for the mental health needs of our members.
A prior authorization is required for the following mental health and substance use services:
- Detox
- Inpatient
- Residential
- Out-of-Network Outpatient
To request a prior authorization or notify Prevea360 Health Plan of an urgent/emergent admission:
- Submit information through the Provider Portal (if you have access)
- Fax request to 608-252-0830 using the mental health prior authorization form
- Call our Customer Care Center at 877-230-7555
Mental health education
Our Mental health provider education annual training is a series of slides for in-network mental health providers navigating care to individuals enrolled in a Prevea360 Health benefit plan.
Additional resources:
Be prepared to provide the following information as necessary (not an inclusive list).
All Services
- Provider tax ID and address
- Member name, birth date and Prevea360 ID number
- Current diagnosis
- CPT codes
- Medications
- Length of authorization
- Clinical information supporting level of care being requested
Inpatient Services
- Admission date
- Attending provider name
- Provider contact person's name and phone number for concurrent review
Notification of an urgent/emergent inpatient mental health or detox admission is required within 24 hours of admission.