State & FederalMedicaidNovember 30, 2018

Empire HealthPlus adopts MCG Care Guidelines for clinical reviews of mental health services

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Starting November 5, 2018, Empire uses MCG Care Guidelines for authorization review of inpatient and outpatient mental health services. We will continue to use LOCADTR for the review of substance-use treatment.

 

Providers should continue to use the phone number indicated on the back of the member ID card for notifications and to request authorization review for these services. Additionally, providers may initiate notifications and requests online at https://www.availity.com.

 

For questions, please call Provider Services at 1-800-450-8753.