Behavioral Health
We partner with Carelon Behavioral Health (Carelon) to administer our behavioral health program for our members.
- To request prior authorization for behavioral health services, call Carelon at 866-444-5155 or visit their website.
- To find a behavioral health provider, search the provider directory on their website.
Carelon Behavioral Health developed a toolkit to assist PCPs in the diagnosis and treatment of mental health and substance use disorders.
Physician decision support line available for behavioral health issues
Carelon Behavioral Health, our behavioral health partner, offers Physician Decision Support Lines for primary care providers to discuss behavioral health issues with Carelon psychiatrists. This includes topics such as psychopharmacology, treatment alternatives and when to refer for a psychiatric assessment. To reach Carelon's Physician Decision Support Line, call 877-241-5575.
We now offer reimbursements for Naloxone kits
WellSense is committed to making Naloxone kits available at all SUD provider sites. In order to ensure SUD providers have these available, WellSense has created a process by which SUD providers are able to submit for reimbursement of kits provided to WellSense members.
Naloxone Kit Reimbursement
To obtain reimbursement for Naloxone kits distributed to WellSense members, please send the following information to WellSense:
- W-9 form
WellSense will reimburse you through its Accounts Payable system, not its claim system, and as such will need a completed W-9 form. The W-9 form is required only the first time a provider submits an invoice. - A completed Vendor Authorization Agreement for ACH Payments.
WellSense will transmit payment via electronic means to your financial institution. Please be sure to include your financial institution details, either in the form of a voided check, or by filling out the appropriate section of the authorization form.
Please note that the address on the ACH Authorization form will be linked to the bank account you provide. Additionally, please be sure that the address used on your invoice matches the address on your ACH Authorization form. - A completed invoice with supporting documentation in the form of a receipt (or copy of receipt) for the cost of the kit(s) that you are billing to Well Sense.
Three ways to submit this information for reimbursement:
Email: Accounts.Payable@wellsense.org
Fax: 617-897-0886
Mail:
Attn: Accounts Payable
WellSense Health Plan
529 Main Street, Suite 500
Charlestown, MA 02129
If you have any questions about this process, please contact Carelon provider relations.
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