Behavioral Health 

Prior Authorization

WellFirst Health provides all Utilization Management services for the behavioral health needs of our members. A prior authorization is required for the following mental health and substance use services:

• Detox
• Inpatient
• Residential
• Partial Hospitalization/Day Treatment
• Intensive Outpatient
• Out-of-Network Outpatient
• In-home therapy

To request a prior authorization or notify WellFirst Health of an urgent/emergent admission:

• Submit information through the Provider Portal (if you have access).
• Fax request to 608-252-0843 using the behavioral health prior authorization form.
• Call our Customer Care Center at 866-514-4194.

Behavioral health education

Our Behavioral health provider education annual training is a series of slides for in-network behavioral health providers navigating care to individuals enrolled in a WellFirst Health benefit plan.

• Behavioral health provider education annual training
• ASAM Criteria for patients and families

Additional resources:

• Behavioral health HEDIS measures

Be prepared to provide the following information (not an inclusive list):

You must notify us of any urgent/emergent inpatient mental health or detox admission within 24 hours of admission