As part of our medical plan, Wake Forest offers a behavioral health plan. We partner with Carolina Behavioral Health Alliance (CBHA), who coordinates coverage for behavioral health and substance abuse services. If you have elected medical coverage through Wake Forest, you are automatically enrolled in the behavioral health plan. You will not receive a separate ID card for this plan.
If you or a covered family member are seeking professional help or information on behavioral health or substance abuse issues, contact CBHA at 1.800.475.7900 (located on the back of the BCBSNC medical ID card) for a confidential assessment and service. A CBHA licensed clinical case manager can help direct you to an in-network provider and assist in assuring that the most appropriate level of care is delivered timely, efficiently, and effectively. For information about network providers, visit the CBHA website.
Inpatient treatment, partial hospitalization, and some intensive outpatient programs require prior authorization by CBHA before receiving treatment. The participant or their treating provider can call CBHA for authorization. Outpatient services requiring prior authorization include: extended treatment sessions (more than 75 minutes), psychological testing, electroconvulsive therapy, home visits by a behavioral health provider, and more than two physician consultations.
Services received by a non-network provider may result in higher out-of-pocket costs than those received by a CBHA network provider. Prior authorization is not required for services performed by non-network providers. Behavior Health Services has a separate $1,000 out-of-pocket maximum for in and out-of-network providers.
Adaptive Behavioral Treatment (ABT)
The behavioral health plan has been expanded to include coverage for ABT. Members can access ABT services by calling CBHA at 800.475.7900. A clinician will help determine the type of services needed, the diagnosis, treatment planning, or therapy, and will direct the member to an in-network provider who can assist with these services. Benefits payable under ABT services are limited to $40,000 per member per year.
The CBHA website offers the following resources:
- Provider Search
- Disease Management Program
- Alcohol Assessment
- Opiates Assessment
- Depression Assessment
- Information on support groups and community resources
- Articles and e-Books about alcohol, depression, and drug abuse
Summary Plan Description
You may refer to the Summary Plan Description for more information on behavioral health coverage.