Payer Policies

Payer-specific coverage, authorization, credentialing and claim-submission requirements for behavioral health services.

52 of 52 topics

Medicaid Billing Software for BehavioralEvaluate Medicaid billing software for behavioral health claims, managed care plans, authorization rules, modifiers, denials, payment posting, and.
Cigna Payer ID (62308): Claims & ERA Routing1 sourceCigna
Behavioral Health Payer Directory7 sourcesInsurance payer directory for behavioral health providers with credentialing guides, prior authorization contacts, VOB numbers, and billing tips.
Aetna for Behavioral Health Providers1 sourceGuide to Aetna credentialing, prior authorization, VOB, and billing for behavioral health treatment centers, rehab facilities, and recovery programs.
AmeriHealth CaritasGuide to AmeriHealth Caritas Medicaid managed care credentialing, prior authorization, VOB, and billing for behavioral health treatment centers.
Anthem Elevance for Treatment Centers1 sourceProvider guide to Anthem (Elevance Health) credentialing, Carelon Behavioral Health authorization, claims, and billing for behavioral health facilities.
Anthem BCBS of New York for Behavioral1 sourceAnthem Blue Cross Blue Shield of New York (formerly Empire BCBS) provider guide: credentialing, prior auth, VOB, and billing for NY behavioral health providers.
BCBS of Massachusetts for Behavioral Health1 sourceBCBS Massachusetts provider guide: credentialing, prior auth, VOB, BlueCard, and billing for behavioral health treatment centers in Massachusetts.
BCBS of Michigan for Behavioral Health1 sourceBCBS of Michigan provider guide: credentialing, prior auth, VOB, BlueCard, and billing for behavioral health treatment centers in Michigan.
BCBS of Tennessee for Behavioral Health1 sourceBlueCross BlueShield of Tennessee provider guide: credentialing, prior auth, VOB, BlueCard, and billing for behavioral health treatment centers in Tennessee.
Beacon Health Options Provider Guide (NowBeacon Health Options merged into Carelon Behavioral Health in 2023. Provider guide with transition history, credentialing, and billing information.
Insurance Billing GuidesExpert insurance billing guides for addiction and mental health treatment centers. Master billing codes, reduce claim denials, and maximize reimbursements.
BCBS for Behavioral Health Providers1 sourceGuide to the Blue Cross Blue Shield system for treatment centers, including credentialing, the BlueCard program, and navigating the 33 independent BCBS plans.
CareFirst BlueCross BlueShield1 sourceCareFirst BCBS provider guide: credentialing, prior auth, VOB, and billing for behavioral health treatment centers in MD, DC, and Northern Virginia.
Carelon Behavioral HealthGuide to Carelon Behavioral Health (formerly Beacon) credentialing, authorization, and billing for treatment centers. Billing and credentialing context for.
CareSource Billing Guide for BehavioralGuide to CareSource Medicaid managed care credentialing, prior authorization, VOB, and billing for behavioral health treatment centers.
Centene / WellCareProvider guide to Centene and WellCare Medicaid behavioral health billing, credentialing, prior authorization, and subsidiary navigation for treatment centers.
Cigna for Treatment Centers and Rehab2 sourcesProvider guide to Cigna and Evernorth Behavioral Health credentialing, prior authorization, claims, and billing for treatment centers and rehab facilities.
ComPsych EAP for Behavioral Health ProvidersGuide to ComPsych EAP credentialing, authorization codes, session limits, care-navigation handoffs, and billing context for behavioral health treatment centers.
Devoted Health1 sourceDevoted Health MA provider guide: Devoted Provider Hub, credentialing, prior auth, CMS appeals, timely filing, and behavioral health billing.
Evernorth Behavioral Health Provider Guide1 sourceGuide to Evernorth Behavioral Health (Cigna
Florida Blue for Behavioral Health ProvidersFlorida Blue provider guide: credentialing, prior auth, VOB, and billing for behavioral health treatment centers in Florida.
HCSC for Behavioral Health ProvidersGuide to HCSC (BCBSIL, BCBSTX, BCBSNM, BCBSOK, BCBSMT) credentialing, prior authorization, VOB, and billing for behavioral health treatment centers.
Health Net for Behavioral Health ProvidersGuide to Health Net credentialing, prior authorization, VOB, and billing for behavioral health treatment centers in California.
Healthfirst NY Billing Guide for BehavioralGuide to Healthfirst NY Medicaid managed care, HARP, and Medicare Advantage credentialing, authorization, VOB, and behavioral health billing in New York.
Highmark for Behavioral Health ProvidersGuide to Highmark BCBS (PA, DE, WV, NY) credentialing, prior authorization, VOB, and billing for behavioral health treatment centers and recovery programs.
Horizon BCBS of New Jersey for Behavioral1 sourceHorizon BCBS of NJ provider guide: credentialing, prior auth, VOB, and billing for behavioral health treatment centers in New Jersey.
Humana Billing Guide for Treatment Centers1 sourceProvider guide to Humana behavioral health billing, credentialing, prior authorization, and claims for addiction treatment and mental health facilities.
Independence Blue Cross for Behavioral1 sourceIndependence Blue Cross provider guide: credentialing, prior auth, VOB, BlueCard, and billing for behavioral health treatment centers in SE Pennsylvania.
Kaiser Permanente Guide for TreatmentKaiser Permanente provider guide for behavioral health — integrated care model, external contracting, and SUD authorization workflows.
Keystone First Billing Guide for BehavioralGuide to Keystone First Medicaid managed care credentialing, prior authorization, VOB, and behavioral health billing in southeastern Pennsylvania.
L.A. Care Health PlanGuide to L.A. Care Health Plan Medi-Cal managed care credentialing, authorization, VOB, and behavioral health billing for providers in Los Angeles County.
Lyra Health EAP for Behavioral HealthGuide to Lyra Health
Magellan Health for Behavioral HealthGuide to Magellan Health credentialing, prior authorization, VOB, and billing for behavioral health treatment centers, rehab facilities, and recovery programs.
Medicaid Guide for Behavioral Health1 sourceMedicaid guide for behavioral health providers covering managed care, IMD exclusion, 1115 waivers, and billing for treatment centers.
Medicare Fee-for-Service for Behavioral12 sourcesOriginal Medicare guide for behavioral health providers covering PECOS enrollment, Part A and Part B benefits, OTP bundled payment, MAC claims, and appeals.
Meridian Health PlanGuide to Meridian Health Plan Medicaid credentialing, prior authorization, VOB, and billing for behavioral health treatment centers in MI and IL.
Modern Health EAP for Behavioral HealthModern Health EAP provider guide: credentialing, session caps, care navigator handoffs, and billing context for therapists and treatment centers.
Molina HealthcareGuide to Molina Healthcare Medicaid behavioral health billing, credentialing, and authorization for treatment centers. Billing and credentialing context for.
Lucet (New Directions Behavioral Health)Guide to Lucet (formerly New Directions Behavioral Health) credentialing, prior authorization, VOB, and billing for behavioral health treatment centers.
Optum Behavioral Health Guide for TreatmentGuide to Optum Behavioral Health credentialing, authorization, billing, and Provider Express for treatment centers. Billing and credentialing context for.
Optum EAPOptum EAP / Live and Work Well provider guide: EAP vs. Optum Behavioral Health, session caps, credentialing, handoffs, and billing context for treatment.
Premera Blue Cross for Behavioral Health1 sourcePremera Blue Cross provider guide: credentialing, prior auth, VOB, BlueCard, and billing for behavioral health facilities in Washington and Alaska.
Regence BCBS for Behavioral Health Providers1 sourceRegence BlueShield provider guide for behavioral health: credentialing, prior auth, VOB, BlueCard, and billing in Idaho, Oregon, Utah, and parts of WA.
SCAN Health Plan for Behavioral Health1 sourceSCAN Health Plan Medicare Advantage provider guide: credentialing, prior auth, timely filing, CMS appeals, and billing in CA, AZ, NV, NM, TX.
Spring Health EAP for Behavioral HealthSpring Health EAP provider guide: credentialing, Care Navigator handoffs, session caps, and billing context for therapists, prescribers, and treatment centers.
Sunshine Health Billing Guide for BehavioralGuide to Sunshine Health Florida Medicaid credentialing, prior authorization, VOB, and behavioral health billing for treatment centers and providers.
TRICARE for Behavioral Health Providers9 sourcesGuide to TRICARE credentialing, prior authorization, VOB, and billing for behavioral health facilities serving military beneficiaries in East and West regions.
UnitedHealthcare for Treatment Centers1 sourceProvider guide to UnitedHealthcare credentialing, prior authorization, VOB, and claims for behavioral health treatment centers and rehab facilities.
VA Community Care Network for Behavioral5 sourcesVA CCN provider guide: credentialing, referrals, prior auth, and billing for behavioral health facilities treating Veterans via Optum and TriWest.
Medicaid Billing Software for BHMedicaid billing software for behavioral health. Real-time eligibility verification, claims tracking, and denial prevention tools.
Behavioral Health Payer Portal DirectoryProvider portals for the largest behavioral health payers and carve-out MBHOs. Quick access to credentialing, prior authorization, VOB, and claim status tools.