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Use for Commercial Members Fax: 8669874161Residential Treatment for Substance Use Disorder AUTHORIZATION REQUESTSubmission of this form is only a request for services and does not guarantee approval.
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Begin by gathering all necessary information, including personal details and insurance information.
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Complete the intake forms provided by the behavioral health substance use facility.
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Be honest and thorough when answering questions about your medical history, substance use, and mental health.
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Consult with a healthcare professional if you have any questions or concerns while filling out the forms.
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Review and sign all necessary consent forms before starting treatment.

Who needs behavioral health substance use?

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Individuals who are struggling with substance use disorders or mental health issues may benefit from behavioral health substance use treatment.
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People experiencing symptoms such as anxiety, depression, addiction, or trauma may also find help through behavioral health services.
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Behavioral health substance use refers to the assessment and treatment of mental health and substance abuse issues.
Healthcare providers, facilities, and organizations involved in the assessment and treatment of behavioral health and substance use disorders are required to file behavioral health substance use.
Behavioral health substance use forms can typically be filled out electronically or on paper, following the specific instructions provided by the governing body.
The purpose of behavioral health substance use reporting is to track and monitor the prevalence and treatment outcomes of mental health and substance abuse issues.
Information such as patient demographics, diagnosis, treatment provided, and outcomes must be reported on behavioral health substance use forms.
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