I have updated contact information for the major national insurance and managed care companies. Check with major employers and unions in your area to identify which ones to pursue. In order to bill a client’s insurance company, you need to apply to be credentialed or “paneled”.
The list has direct links to provider relations information on the web as well as details outlining the number of insured lives covered, necessary paperwork and reimbursement rates.. Information on the number of covered lives is taken from a study by Harvard University’s John F. Kennedy School of Government Mossavar-Rahmani Center for Business and Government. We compiled information regarding payment and paperwork requirements from insurance and managed care websites as well as surveys of licensed counselors.
This past year included many mergers among these companies. Counselors should note that these changes could offer opportunities as the companies expand into new areas. This is a good time to consider applying to become a provider to these companies. Remember, persistence will pay off when applying to become a provider or even when asking to be considered for an increase in reimbursement rates.
|• Blue Cross/Blue Shield (Various states)
(covers 11 million)
AMERICAN PSYCH SYSTEMS/ APS Healthcare (Maryland)
BENEFIT ADMINISTRATIVE SYSTEMS, LTD various regions
BEHAVIORAL HEALTH SYSTEMS, INC. *National
BLUE CROSS/BLUE SHIELD
BSSI/ BENEFIT SYSTEM AND SERVICE INC. (Illinois)
COMMUNITY CARE NETWORK/CCN COMMONWEALTH ADMINISTRATORS/CHA HEALTH
COMPREHENSIVE BEHAVIORAL CARE/ COMP CARE
COMPSYCH BEHAVIORAL HEALTH CORP.
EMPLOYEE ASSISTANCE PROGRAMS AND CONTACT INFORMATION LIST (*important national comprehensive list of EAP’s)
FIRST HEALTH SERVICES, INC.
GEN AM BENEFITS/ GREAT WEST (Midwest States Only)
|• Ceridian /Lifeworks (National)
GUARDIAN (affiliated with CORPHEALTH)
THE HOLMAN GROUP
HORIZON BEHAVIORAL HEALTHCARE MANAGEMENT CORP.
HUMANA EMPLOYERS HEALTH
MAGELLAN BEHAVIORAL HEALTH
MANAGED HEALTH NETWORK
PACIFICARE BEHAVIORAL HEALTH *National
PLANNED BEHAVIORAL HEALTHCARE, INC. (affiliated w/MHN)*National
UNITED BEHAVIORAL HEALTH, INC.
UNITED HEALTHCARE INSURANCE CO.
The following strategy has been used to respond to denials by an insurance claim or
refusal to allow a clinician to be a member of a managed care panel. For the most
effective response, a letter should be sent by the client and the counselor.
A letter is sent from the client to the managed care or insurance company explaining why
they wish to see this particular licensed counselor. A copy (cc) is sent to the client’s company
The counselor sends an appeal to both the client’s employer benefits manager and
managed care or insurance company outlining the counselor’s credentials and giving the
reason the client was referred to him/her. Always have the client sign a release so this letter can be sent.