Substance use disorder treatment authorizations
Behavioral health fax process
In network providers
In network providers can submit authorizations using GuidingCare.
Out of network providers
Send a separate fax for each individual patient. Faxes referencing more than one patient will be returned for resubmission.
1. Complete the form for the service you're requesting and use it as the cover sheet for your fax.
2. Identify the evaluating facility/agency contact's name and phone number on the auth form/cover sheet.
3. Attach complete clinical notes or the screening form to ensure that we have all available clinical data to review.
Requirements for clinical notes
Computer-generated or typewritten notes are preferred. Hand-written documentation may delay the review process and require extra phone calls to clarify information and clinical content.
- CIWA or COWS score if available
- All vitals including blood pressure, pulse, temperature and respirations
- Any specific withdrawal symptoms that the patient is currently exhibiting
- The specific dates of any transfers from one level of service to another