Prior Authorization Process – Behavioral Health Services
Bravo Health maintains requirements for provider to obtain Prior Authorization for certain Behavioral Health Services. To find out more about the Prior Authorization process for Behavioral Health Services, select one of the following:
Requests for authorization that are made after hours are reviewed the next business day.
To determine the status of an authorization request, call the Prior Authorization Department at 1-877-562-4402.
List of Behavioral Health Services that require Prior Authorization
The following Behavioral Health Services require Prior Authorization:
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All Inpatient Admissions
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All Partial Inpatient Admissions
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Outpatient therapies beyond 30 visits
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Psychological and Neuropsychological testing
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Electroconvulsive Therapy (ECT)
Requests for authorization that are made after hours are reviewed the next business day.
How to Request Prior Authorization for Behavioral Health Services
There are two ways to request a prior authorization.
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Fax a Prior Authorization Form for Behavioral Health Services to Bravo Health at the applicable fax number listed below.
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Inpatient:
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1-877-809-0786
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Other Outpatient Requests:
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1-877-809-0787
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Speak with a Bravo Health representative in the Prior Authorization Department at 1-877-562-4402.
Prior Authorization Process
Bravo Health prioritizes prior authorization requests according to medical necessity. If a prior authorization request is approved, Bravo Health issues an authorization number that should be used for billing. Bravo Health faxes the approved Prior Authorization Request Form and the authorization number to the requesting provider according to the following timeframes:
Requests for authorization that are made after hours are reviewed the next business day.
To determine the status of an authorization request, call the Prior Authorization Department at 1-877-562-4402.
Standard Prior Authorization Request
If all required information is submitted at the time of the request, Bravo Health will respond to a Prior Authorization Request Form within three (3) business days of receipt of the request.
Expedited Authorization Request
An expedited request can be requested if a Provider believes that waiting for a decision under the standard request timeframe could place the Member’s life, health, or ability to regain maximum function in serious jeopardy. To request an expedited authorization, Providers should call 1-877-562-4402.
Emergency Admissions & Services
Prior authorization is not required for Emergency Services. However, Providers must notify Bravo Health of Emergency Services within twenty-four (24) hours or by the next business day, whichever is later.
Post Stabilization Prior Authorization Request
Post-stabilization requests can be made for covered services related to an Emergency Medical Condition provided after a Member has been stabilized. Bravo Health will respond to post-stabilization requests within one (1) hour.
Behavioral Health Authorization Forms
Bravo Health maintains the following Prior Authorization Forms for Behavioral Health Services.
Requests for authorization that are made after hours are reviewed the next business day.
To determine the status of an authorization request, call the Prior Authorization Department at 1-877-562-4402.
Inpatient Authorization Form
Providers should use the Inpatient Authorization Form to request authorization for an elective admission to any inpatient Medical or Behavioral facility.
Behavioral Health Outpatient Service Notification Form
Providers should use the Behavioral Health Outpatient Service Notification Form when they begin to treat a patient for outpatient Behavioral Health services. This is a notification only to Bravo Health’s Service Coordination team and Bravo Health does not issue a Prior Authorization upon receipt.
Behavioral Health Extended Therapy Authorization Form
Bravo Health requires providers to obtain Prior Authorization for Behavioral Services in excess of 30 outpatient visits. Providers should request Prior Authorization as of the 24th visit to ensure they receive approval of their request in advance of the 30 visit milestone. Providers should use the Behavioral Health Extended Therapy Authorization Form to request Prior Authorization for Behavioral Health services in excess of 30 visits.
Psychological / Neuropsychological Testing Request Form
Bravo Health requires providers to obtain Prior Authorization for psychological and neuropsychological tests. Providers should request Prior Authorization for these services by using the Psychological/Neuropsychological Testing Request Form to request Prior Authorization for Behavioral Health services in excess of 30 visits.