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Behavioral Health Management

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Effective January 1, 2008, Empire has assumed responsibility for managing behavioral health and substance abuse benefit services for more than two million members, through an internal department. Empire’s behavioral health provider network is open to Psychiatrists, Psychiatric Nurse Practitioners, Psychologists and Licensed Clinical Social Workers who are successfully credentialed through Empire. Member benefits will vary based on Plan and Product, it is recommended that benefits and eligibility are verified prior to treatment commencing, to ensure participation and accurate utilization management rules are applied throughout treatment.  
 
Additional Information
2010 Behavioral Health Medical Necessity Criteria, Effective January 1, 2010
2011 Behavioral Health Medical Necessity Criteria, Effective January 1, 2011
Immediate Announcement: 2008 Outpatient Behavioral Health Pass-Through Visits
Additional Participating Behavioral Health Providers for Empire National Account Members
Interchangeable Outpatient Codes
 

Forms

Coordination of Care Letter Template

PDF Format

FEP Outpatient Treatment Report (OTR) Form

PDF Format

Individual Authorization Form

PDF Format

Outpatient Treatment Report

PDF Format

Provider Maintenance Form

PDF Format

Provider Specialty Profile

PDF Format

Psychological Testing Authorization Form

PDF Format

Psychotherapy Notes Authorization Form

PDF Format

FAQs

Institutional FAQs

PDF Format

Professional FAQs

PDF Format

Quick Guides

Institutional Quick Guide

PDF Format

Professional Quick Guide

PDF Format

 
©2009 Empire BlueCross BlueShield

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. All external sites will open in a new browser window. Please view our Website Privacy Policy for more information.