Behavioral Health
Welcome to the UnitedHealthcare Community Plan of Tennessee Behavioral Health Homepage. Please navigate the categories below to locate all of the information you need, organized all in one easy to navigate location. You may also use the navigation on the left to quickly find what you're looking for pertaining to non Behavioral Health resources.
TennCare CoverKids Applied Behavioral Analysis (ABA) Program
Behavioral Health Information and Forms
- Behavioral Health Facility-Agency Site Audit Tools
- Declaration of Mental Health Treatment Information and Forms (TN Government Site)
- IECMH Program and Services Provider Attestation
- IECMH Program Description, Assessment and Treatment
- Provider Evaluation of Performance (PEP) Plan
- TennCare Behavioral Health Adverse Occurrence Report Form
- Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS)
- TennCare Medicaid Network Only: Clinician Tax ID - Add / Update Form
Join the Network
The forms are manual and should be submitted for processing as follows:
- Submit Completed Applications to uhccp_bhnetwork@uhc.com
- To check your credentialing status, please call 800-817-4705
Forms:
- Agency Application
- TennCare Facility Application
- Behavioral Health Facility Credentialing Application: Short
- Facility Integrated Credentialing Application
- Network Participation Request Form
My Practice Profile
Update and attest to your care provider demographic data. Use the tool to make demographic changes, update and attest to your provider demographic information. Access My Practice Profile.
Levels of Care and Services Not Utilizing ASAM or Milliman Criteria
UnitedHealthcare Community Plan currently utilizes the following Level of Care Guidelines (LOCGs) to conduct medical necessity reviews of requests for services as they apply to available Behavioral Health benefits.
ASAM 3rd Edition criteria are currently utilized for all Substance Abuse services. ASAM criteria are proprietary and cannot be given to providers or members unless a denial of service(s) is rendered, at which time a copy of the criteria in question can be obtained upon request.
Providers wishing to access these criteria independently may purchase them through the ASAM American Society of Addiction Medicine (American Society of Addiction Medicine- Patient Placement Criteria, 3rd Edition).
- Acute Inpatient Hospitalization
- Behavioral Respite Services
- Community Assessment and Stabilization Team (CAST)
- Comprehensive Child & Family Therapy (CCFT)
- Continuous Treatment Team (CTT)
- Crisis Stabilization Unit (CSU)
- Intensive Outpatient Program
- Level of Care Guidelines: Applied Behavioral Analysis
- Outpatient
- Partial Hospital Program
- Program of Assertive Community Treatment
- Psychosocial Rehabilitation
