Welcome to the Value Behavioral Health of Pennsylvania (VBH-PA) HealthChoices  Provider Network.  As a VBH-PA network provider, you join a group of the most respected behavioral health care professionals in the country – individuals who share our commitment to advancing the Commonwealth’s vision of a comprehensive delivery system that assures easy access to quality mental health and substance abuse care.  We are pleased to welcome you to the VBH-PA HealthChoices Behavioral Health Program.

This manual has been developed to answer your questions about the behavioral health component of the HealthChoices Program and to explain how VBH-PA coordinates the delivery of mental health and substance abuse care to covered individuals.  Covered individuals include the Pennsylvania Department of Public Welfare (DPW) Medical Assistance recipients who are enrolled in HealthChoices.  They will be referred to in this manual as “members”.

The manual begins with an introduction to the HealthChoices Program, followed by a listing of services covered under the program.  The VBH-PA workflow process is outlined in its entirety, beginning with referring the member to providers and the authorization of services, to claims submission and payment, as well as assisting with problem resolution.  All necessary forms are included in the applicable section for your use or readily available on our VBH-PA web site.  Your adherence to the guidelines presented in this manual will assist VBH-PA in providing you with timely service authorizations and claims reimbursement.  

Should you have any questions or comments while reading the manual, or at any other time, please call our toll-free provider number at 877-615-8503.  The toll-free provider number is also listed in the “Quick Reference Guide”, along with other pertinent telephone numbers and information.

Thank you for your participation in our provider network.  We look forward to a long and mutually rewarding relationship as we work together to provide responsive treatment and support to HealthChoices members.

Important Notice:  This manual explains many important aspects of the behavioral health component of the HealthChoices Program.  Together, the manual and the VBH-PA participating provider agreement outline the requirements and procedures that network providers must follow to be included in the VBH-PA network.  VBH-PA reserves the right to interpret and construe any terms or provisions in this manual and to amend it, at its sole discretion, at any time.  To the extent that there is an inconsistency between the manual and the participating provider agreement, the participating provider agreement provisions shall govern.