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Providers

Precertification Requirements


Behavioral Health

To request precertification for outpatient services: Fax 1-800-370-1116

To request precertification for Inpatient, IOP, PHP, SIPP or RTC: Call Beacon Health Options at 1-844-375-7215

For more information regarding precertification requests for Behavioral Health, visit  Beacon Health Options or call 1-844-375-7215.

For providers wanting to join Beacon’s Network, call: 1-786-837-2850

Services billed with the following revenue codes ALWAYS require precertification:
0240–0249 — All-inclusive ancillary psychiatric
0901, 0905–0907, 0913, 0917 — Behavioral health treatment services
0944–0945 — Other therapeutic services
0961 — Psychiatric professional fees

Pharmacy

Check our  preferred drug list

Services billed with the following revenue codes ALWAYS require precertification:
0632 — Pharmacy multiple sources

Long-Term Services and Supports

Providers needing an authorization should call 1-877-440-3738.

The following ALWAYS require precertification:
Elective services provided by or arranged at nonparticipating facilities

All services billed with the following revenue codes:
0023 — Home health prospective payment system
0570–0572, 0579 — Home health aide
0944–0945 — Other therapeutic services
3101–3109 — Adult day and foster care

Precertification Tool

To request or check the status of a precertification request or decision, please login to Availity.


 

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Related resources

 
 

Provider tools & resources

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