Behavioral Health

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The Behavioral Health Medical Necessity Criteria document has been divided into several Clinical UM Guidelines and can be found at the link below under the Behavioral Health category:

Behavioral Health Clinical UM Guidelines

CG-BEH-03 – Psychiatric Disorder Treatment

CG-BEH-04 – Substance Abuse Treatment

CG-BEH-05 – Eating Disorder Treatment

CG-BEH-06 – Psychiatric Outpatient Treatment

CG-BEH-07 – Psychological Testing

Other Coverage Guidelines and Clinical UM Guidelines can be found at this link: Coverage Guidelines and Clinical UM Guidelines
 
How Anthem Can Help  
Anthem Virginia Behavioral Healthcare has assisted members with mental health and substance abuse benefits and services for twelve years. Our case managers and customer service representatives are available to provide confidential assistance with benefit questions, locate a provider, coordinate care, and discuss your specific treatment needs. If we can assist you, contact us at (800) 991-6045.  
How To Find a Provider  
Providers may be a facility or program, a psychiatrist, a licensed clinical psychologist, a licensed clinical social worker, a licensed professional counselor or a clinical nurse specialist. Contact us at (800) 991-6045 for assistance with provider information or to locate a provider. Or you can search our online directory.  
What You Should Know About Anthem Providers  
All of the providers participating in the Anthem Virginia Behavioral Healthcare network must meet our credentialing standards. These standards include those for the National Committee for Quality Assurance (NCQA). As your health care plan, we are committed to establishing relationships with providers and working closely with them to further the quality of care for our members. We meet regularly with provider committees statewide to review treatment patterns, practice guidelines and to provide data to assist providers in making informed clinical decisions. 

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