Prior Authorization

WellFirst Health provides all Utilization Management services for the behavioral health needs of our members. See our Medical Prior Authorization Services List to confirm which behavioral health services require prior authorization.

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

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

All services 

  • Provider tax ID and address
  • Member name, birth date and WellFirst Health ID #
  • Current diagnosis
  • CPT codes
  • Medications
  • Length of authorization
  • Clinical information supporting level of care being requested

Inpatient services

  • Admission date
  • Attending health care provider name
  • Provider contact name and phone number for concurrent review
YOU MUST NOTIFY US OF ANY URGENT/EMERGENT INPATIENT MENTAL HEALTH OR DETOX ADMISSION WITHIN 24 HOURS OF ADMISSION.