Behavioral health
Benefits are managed through Carelon Behavioral Health.
We work with Carelon Behavioral Health for our mental health and substance use programs.
Services including preauthorization, discharge planning and after-care monitoring are provided by Carelon. These programs are coordinated by clinical experts who have access to resources 24/7.
Preauthorization is required for certain services. Please refer to our Single Source List located on the Provider Portal for list of services requiring preauthorization.
Contact Carelon at:
- Commercial PPO, POS, Comprehensive, and Traditional members Call 866.322.1657
- For Commercial HMO, Children’s Health Insurance Program (CHIP) HMO, and Medicare Advantage (BlueJourney PPO and BlueJourney HMO) members Call 800.216.9748
- For Federal Employee Program (FEP) PPO members (Facility Only) Call 800.356.7986 for Federal Employee Program (FEP) PPO members (Facility Only)
As of January 1, 2025, Carelon Behavioral Health will no longer be Capital Blue Cross’ behavioral health manager for mental health and substance use disorder services. Moving forward, Capital Blue Cross will offer services to support mental health and substance use. Services include preauthorization, discharge planning and after-care monitoring for Capital Blue Cross members.
Beginning January 1, 2025, you can initiate a preauthorization request by accessing the Preauthorization application via Our Provider Portal. Here you will be able to perform a preauthorization inquiry, request preauthorization for Inpatient and Outpatient services, request a preauthorization for a Member to see a non-Participating Provider and perform a pre-service review for out-of-area Members.
Note: Some employer groups have made alternative arrangements for behavioral health services for their employees. In those instances, the Member’s ID card contains information about behavioral health benefits. In the event alternative arrangements for behavioral health services need to be made, the Member is responsible for obtaining such services in accordance with the benefits provided by their employer.