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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:

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.