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Provider : Behavioral Health

WellCare provides behavioral health benefits to members enrolled in Georgia Medicaid plans. The plan provides integrated medical and behavioral health services for members. We are committed to quality service and partnership with providers to ensure members get the most of their benefits.
 

The following information provides a summary of our Georgia Medicaid behavioral health program. Complete information is available in the behavioral health section of the Provider Handbook.
 

Authorizations
Information about authorization requirements and criteria. 


Billing Guidelines

 

Clinical Coverage Guidelines
Evidence-based guidelines detailing the medical necessity of procedures or technologies.

 

Clinical Practice Guidelines
Best-practice recommendations based on available clinical outcome and scientific evidence.

 

Case and Disease Management
WellCare offers Case and Disease Management programs specifically designed to assist with behavioral health issues such as depression and substance abuse. Please see the Provider Handbook for complete information on how to refer a member.
 

Accessing Behavioral Health Providers
Our provider search tool can help you and members find participating providers and facilities in each region that WellCare has been contracted to provide Medicaid managed care services.
 

Continuity and Coordination of Care
WellCare’s integrated care model strongly encourages communication between behavioral health providers and PCPs. To maintain continuity of care, patient safety and member well-being, this exchange is critical, especially for members with co-morbidities receiving pharmacological therapy. Please see the Provider Handbook for complete information.
 

Behavioral Health Advisory Council
WellCare values the input of our behavioral health members, advocates and providers. A Behavioral Health Advisory Council will be established to assist with WellCare services and programs, and meet the needs and expectations of the behavioral health community. 
 

Provider Portal
Our secure Provider Portal provides access to additional important information such as authorization requests, member eligibility, claims, provider inquiries and more. If you don’t have an account, it’s easy to register today.
 

Medicare Advantage

Effective December, 1, 2013, behavioral health services transitioned from Magellan to the WellCare Behavioral Health Integrated Program. This change will enable a holistic approach to care in which one integrated care management team is responsible for both medical and behavioral health.

 

Last modified: 02/11/2014
 

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