WellCare provides behavioral health benefits to members enrolled in our Medicaid plans. We are committed to quality service and partnership with providers to ensure members get the most of their benefits.
Some behavioral health services may require prior authorization, including services provided by non-participating providers. Obtaining appropriate authorization is essential to providing needed care.
WellCare uses the following:
- North Carolina Behavioral Health Clinical Coverage Policies
- WellCare of North Carolina Clinical Coverage Guidelines
- American Society of Addiction Medicine, Inc. (ASAM): Assesses level of care determinations for substance-related disorders.
- Milliman Care Guidelines (MCG): Assesses level-of-care criteria