Advocate Support Services

Concurrent Referral for Continued PRP Services

Maryland requires a signed referral from an individual’s treating outpatient mental health provider at least every 6 months for Psychiatric Rehabilitation Program (PRP) services to continue. Advocate needs this referral before requesting continued authorization from Carelon Behavioral Health of Maryland. The secure form takes about 3 minutes.

Who can complete this form

• The individual’s current treating outpatient mental health provider, independent of Advocate
• Accepted credentials: MD/DO, APRN-PMH/CRNP-PMH, PhD/PsyD, LCSW-C, LCPC, LCMFT, LCADC, LCPAT
• LMSW, LGPC, LGMFT, LGADC, and LGPAT clinicians, with their licensed supervisor listed

Have these ready

• The date of your most recent visit (within the last 60 days)
• The current diagnosis and a brief clinical rationale
• Your individual NPI and Maryland Medicaid enrollment status

Referring someone new to Advocate? Use our Referral Form.

Questions? Call (866) 277-2080, extension 2.