Behavioral Health Access
Welcome to CDPHP Behavioral Health Services
Management of behavioral health services is now handled in-house by CDPHP.
The CDPHP behavioral health benefits access number is 1-888-320-9584. Call that number to verify eligibility and benefit information prior to rendering care.
Pending determination of eligibility and benefits, no authorization will be required for the first 10 visits/treatments you provide a member. If treatment is needed beyond the 10 pass-through visits, an Outpatient Treatment Report (OTR) will be required to certify additional visits.
Behavioral health providers: Learn more by downloading a tip sheet and viewing the answers to some frequently asked questions. If you have not yet joined the growing panel of CDPHP behavioral health providers and would like to do so now, please complete a data collection form to begin the process.
How CDPHP Manages Members’ Behavioral Health
Members may access care by calling the Behavioral Health Access Center at 1-888-320-9584, Monday through Friday, 8 a.m. to 6 p.m.
The CDPHP behavioral health utilization management (UM) process includes triage and referral as well as prospective, concurrent, and retrospective review of services delivered to CDPHP members.
The UM program is designed to ensure that members receive timely access to appropriate, affordable, quality behavioral health care services. Our goal is total health management. The behavioral health care services that are reviewed include inpatient hospitalizations, prior authorizations of out-of-network services, case management services, outpatient services, and substance abuse rehabilitative services.
Access Standards and Coverage Arrangements
CDPHP has behavioral health staff available 24 hours a day, seven days a week to facilitate inpatient admissions. CDPHP network providers are required to ensure that members have access to care within the following standards:
- Emergency—Immediate access (may be referred to the ER)
- Urgent appointment—within 48 hours
- Initial routine appointments—within 10 business days
- Ambulatory appointment post-inpatient discharge—within 7 days of discharge
Need More Info?
Participating providers are urged to log into the secure provider site to view the Provider Office Administration Manual and CDPHP policies. If you have any questions or need additional assistance, please contact CDPHP Provider Services.