Behavioral Health Services
Cook Children's Health Plan will work in partnership with our network Providers to manage the delivery of mental health and substance use disorder services for CHIP, STAR, and STAR Kids Members.
The primary goal of the program is to provide medically necessary care in the most clinically appropriate and cost-effective therapeutic settings. By ensuring that all Cook Children's Health Plan Members receive timely access to clinically appropriate behavioral health care services, Cook Children's Health Plan believes that quality clinical services can achieve improved outcomes for our Members.
Improved health outcomes can be achieved by providing Members with access to a full continuum of mental health and substance use services through our network of contracted Behavioral Health Providers.
How to Submit a Prior Authorization
For behavioral health authorizations, Cook Children's Health Plan accepts prior authorization requests via the Secure Provider Portal.
Providers pending access to the Secure Provider Portal may submit requests by fax:
- Fax: 1-682-303-0005 or 1-844-843-0005 STAR KIDS
- Fax: 1-682-885-8402 STAR/CHIP
Provider inquiries may be sent to CCHPPriorAuthorizations@cookchildrens.org
Please reserve this email for inquiries only. We request that this is not utilized for routine prior authorization requests.
Behavioral Health Provider and Primary Care Provider Coordination of Care
Behavioral Health Providers are expected to communicate at least quarterly or more frequently, if necessary, regarding the care provided to each Member with other Behavioral Health Provider and Primary Care Providers.
The following forms are tools intended to help facilitate communication between Providers and may serve as a model for the exchange of clinical information between Behavioral Health Providers and Primary Care Providers. Cook Children’s Health Plan believes that through communication and coordination of care, disruptions and delays in treatment may be prevented and poor health outcomes averted.
Notifying Cook Children's Health Plan of Reportable Events
Reportable events (also known as Critical Incidents) are incidents or outcomes involving Cook Children’s Health Plan (CCHP) Members seeking or receiving services from in-network Providers that may require further analysis. They also include events that occur during a patient’s transition to home or an alternative level of care. Tracking of reportable events is a contractual requirement for our Providers, so it is important to report an occurrence promptly.
Notification to CCHP that a reportable event has taken place must be documented on the Reportable Event Form. The form must be sent to the Quality Improvement Department via email to CCHPQualityImprovement@cookchildrens.org or by facsimile to 682-885-8494 as soon as reasonably possible, but ideally within one business day of the date you became aware of the event. Written supplemental notes or a copy of clinical records may be requested.
Mental Health Targeted Case Management and Mental Health Rehabilitative Services
Mental Health Targeted Case Management and Mental Health Rehabilitative Services Providers must submit the Targeted Case Management and Rehabilitative Services Request Form with all prior authorization requests. Prior authorization requests should be submitted via the Secure Provider Portal.