As a reminder, BCBSRI in-network and out-of-network behavioral health services only require a notification of admission.

Per this process, admitting facilities must notify BCBSRI behavioral health within 48 hours of a member’s admission to/discharge from any one of the following levels of care, to ensure correct claims processing:

• Inpatient mental health
• Inpatient withdrawal management (detoxification)/rehab
• Crisis stabilization
• Residential treatment center (mental health and/or substance use disorder)
• Partial hospitalization (mental health and/or substance use disorder)
• Intensive outpatient (mental health and/or substance use disorder)
• Child and family intensive treatment (CFIT)
• Applied behavior analysis (ABA)
• Transcranial magnetic stimulation (TMS)

Of note, the Federal Employee Program (FEP) is exempt from the notification of admission process. A medical necessity review is still required for the following in-network behavioral health services:

• Inpatient mental health
• Inpatient withdrawal management
• Residential treatment center (mental health and/or substance use disorder)
• Applied behavior analysis (ABA)
• Transcranial magnetic stimulation (TMS)