Currently, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) State Health Plan members' behavioral health services have been managed by Beacon Health Options. Members that require intensive/complex case management services were managed by Beacon Health Options and members with dual behavioral and medical issues are managed by our health care support team for co-management with the medical case managers. In the coming months, behavioral health services and management will be entirely insourced.
Starting January 1, 2022, the following changes will take place:
- Blue Cross NC’s State Health Plan (SHP) team will assume care for all behavioral health intensive case management (complex case management) and the Commercial team will take on utilization management responsibilities from Beacon Health Options.
- Providers will need to work with Blue Cross NC instead of Beacon Health Options to request authorization for services on Prior Plan Authorization (PPA).
- The provider community can speak to a behavioral health case manager by calling 833-298-1069. New options will be available to providers to submit a PPA for SHP members. Providers can call the telephone number that is on the back of the membership card, 800-367-6143 to reach an intake specialist directly, complete a fax form and fax it to 866-987-4161 or utilize the Blue e authorization portal.
- Providers can email the behavioral health mailbox at BehavioralHealth@bcbsnc.com for questions related to these changes.
Quartet Expansion to the State Health Plan
Additionally, beginning January 1, 2022, Blue Cross NC will be expanding our Quartet Health program to include State Health Plan members. Quartet is a platform as well as a service that enables the integration of physical and behavioral health services. Quartet Health does not provide direct mental health care. It is a free support service that works to find members care based on their clinical needs, insurance plan and personal preferences. Quartet will be a vendor resource option available to connect SHP members with outpatient behavioral health services beginning in 2022.
Providers will not need to make any changes because of this expansion. Quartet was already payer-agnostic.
For questions or concerns about the Quartet expansion or the behavioral health insourcing process for Beacon Health Options, providers can email BehavioralHealth@bcbsnc.com.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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