This section offers key information about Behavioral Health services for providers. While it is primarily intended for Behavioral Health (BH) providers, medical providers may also find helpful insights to support patients with behavioral health needs. The information listed below is not all-inclusive. Be sure to always check your patient's benefits in Eligibility & Benefits or your practice management system.

Blue Choice

Blue Choice is a fee-for-service product where patients have a copay for behavioral health services.

Blue Choice providers who need assistance with provider enrollment and contracting, clinical criteria, precertifications, standards of care and related matters should contact Lucet at 1-888-611-6285, Option 3.

For Blue Choice providers who have claims status or remittance questions, first review the information on ProviderAccess, then contact Customer Service.  Blue Choice providers can also contact us at 1-866-904-4130.

Expanded Psychiatric Services

Expanded Psychiatric Services (EPS) is a managed care product. Providers who need assistance on EPS patients should contact Lucet at 1-888-611-6285, Option 3.

Behavioral Health Carve-Outs

Some employer groups choose to carve out behavioral health services to another company to manage costs. When this happens, Blue Cross and Blue Shield of Alabama does not process claims for behavioral health services for those patients.

Behavioral health services including mental health and substance use treatments may be covered by a third-party vendor that is separate from the medical plan.

To determine whether behavioral health services are carved out for a specific patient, check Eligibility and Benefits before providing services. Contact the company listed there for claims and service-related questions.

Disclaimer: Blue Cross does not partner with any entity to carve out services based on behavioral health diagnosis (BH Dx). Carve-outs are determined by diagnosis, not by provider specialty.

Lucet

To manage the behavorial health needs of your patients, Blue Cross and Blue Shield of Alabama contracted with Lucet Health, formerly New Directions, as our Behavioral Health Benefit Manager (BHBM).

Lucet enrolls and contracts with providers, including management our provider networks, manages precertifications/preadmission certifications, performs case management, and serves as a resource for all behavioral health needs.  They also perform provider customer service and, in some cases, member/patient customer service. Lucet can also provide invaluable assistance with clinical matters and recommend protocols when needed.

Resources

• Behavioral Health Assistance
  To make a case management referral, arrange a call with a psychiatrist, or seek other behavioral health assistance, call Lucet’s physician help line at 1-855-339-1598. This line is available 24/7, including holidays. For general information on Behavioral Health programs, visit Lucet’s website.
• Discharge Planning
  If you need help with follow-up appointments after discharge for inpatient behavioral health patients, call the Discharge Planner Hotline at 1-800-765-9124. This direct line connects to our Clinical Support Team, which will conduct a screening and schedule a follow-up appointment with the patient.
• Provider Portal
  Manage patient information, referrals, and access additional support services.
• Toolkit
  Access practical tools and resources to support behavioral health care delivery.

Out-of-Network Providers

Out-of-Network providers with questions about Behavioral Health should call Customer Service at 1-205-733-7016.

Additional Information

Major Depression Guideline for Initial Outpatient Treatment of Adults, 2015
Source: American Psychiatric Association and collaboration with Lucet

Importance of Follow-Up After Hospitalization for Mental Illness
Source: National Committee for Quality Assurance (NCQA)

Lucet is an independent company offering behavioral health solutions and services on behalf of Blue Cross and Blue Shield of Alabama.