PacifiCare Behavioral Health Overview
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PacifiCare Behavioral Health is a wholly owned subsidiary of PacifiCare Health Systems serving over 4 million members. As a managed behavioral health organization, PBH manages a variety of behavioral health business in Pennsylvania:
Keystone Health Plan Central (Commercial fully insured and self-insured, and SeniorBlue) membership except for the following employer groups:
| | Lehigh University | | Stanley Works |
| | Air Products and Chemicals | | AAI Corporation |
| | PEBTF | | Mack Trucks |
| | Wachovia | | adultBasic |
For members in these employer groups, behavioral health benefits are not provided through nor covered by KHP Central. Information on behavioral health coverage may be found on the member's insurance ID card, or you may ask the member to check with his/her employer regarding coverage for behavioral health services.
PacifiCare Behavioral Health provides services to other members whose employers choose PBH as a specialty behavioral health carrier.
Remember This About PBH Referrals
All services (including psychological testing) must be pre-authorized. Make sure you or the member contacts PBH prior to the first appointment.
Once the initial authorization has been made by PBH, it is the provider's responsibility to obtain authorization for additional sessions if needed.
All services are to be provided by the PacifiCare Behavioral Health credentialed/contracted provider named on the authorization.
If you have not received an authorization and a member, a member's Primary Care Physician or family member is requesting an appointment, please schedule the appointment and contact PBH at (800) 216-9748 for authorization.
Primary care physicians may contact PBH to make a referral for one of their members.
Written authorization forms will be sent immediately upon authorization. Contact PBH if you have not received your authorization.
 
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