Behavioral Health Overview
Regence Behavioral Health provides online tools for efficient communication from your office to ours.
Mental Health and Chemical Dependency Pre-authorization
Please reference the Pre-authorization section for Mental Health and Chemical Dependency pre-authorization information.
Clinical Practice Guidelines
The Mental Health and Chemical Dependency Treatment practice guidelines describe generally accepted practices and were developed by nationally recognized organizations.
Behavioral Health Clinical Review Criteria
Regence utilizes Milliman Care Guidelines, Regence Medical Policy and CMS Policy for medical necessity determinations.
The Milliman Behavioral Health Guidelines are evidence-based criteria that are widely used within the health care industry. The criteria are available for purchase through Milliman or you may request a copy of the guidelines for a specific service by calling one of the following phone numbers:
- Federal Employee Program (FEP): 1 (866) 873-9743
- Group, Individual and Medicare Products: 1 (800) 780-7881
| Behavioral
health pre-authorization forms |
| Form |
Description |
Instructions |
| Outpatient Mental Health
Treatment Plan (PDF) |
This form is for Federal Employee Program (FEP) members.
A treatment plan is requested, but not required, for members with FEP primary coverage. |
Call FEP Customer Service at 1 (877) 668-4654 in order to verify the type of coverage, benefits, eligibility, co-payments, and deductible.
Please fax the completed form to 1 (888) 496-1540. |
| Behavioral Health Outpatient Treatment Plan Request |
This form is for members who require an authorization for behavioral health outpatient treatment, including chemical dependency.
Submit this form to Regence for authorization of continued services. |
Please call Regence Behavioral Health Customer Service at 1 (888) 496-1540 for any authorization questions.
Complete the Treatment plan request form securely online or you may download the form (PDF) and submit by fax to Regence Behavioral Health 1 (888) 496-1540. |
Revised December 2011
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