Prior Authorization for Out of Network Behavioral Health Services
Effective September 1, 2025, Meridian will implement a policy requiring prior authorization for members to receive services from out-of-network Behavioral Health (BH) providers. This policy change is intended to support high-quality, coordinated care, and ensure the appropriate use of network resources.
What You Need to Know:
- The requirement does not apply to emergency room care, urgent care, or services rendered at a Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), or Tribal Health Center (THC).
- Members should use the “Find a Provider” tool or contact Member Services to verify if their Behavioral Health provider is in-network.
Join Our Network:
Become a participating provider by joining our network! To find out more information, submit a request on our Join our Network page.
How To Check Your Status:
Providers can check their network status by calling the dedicated Provider Service departments for assistance:
- Meridian (Medicaid): 1-888-773-2647 (TTY: 711)
- WellCare (Medicare): 1-855-538-0454 (TTY: 711)
- MeridianComplete (Medicare-Medicaid Plan): 1-855-323-4578 (TTY: 711)
- Ambetter (Health Insurance Marketplace): 1-833-993-2426 (TTY: 711)
For information regarding our prior authorization requirements for non-BH providers, please see our previous bulletin regarding out of network prior authorizations.