• For Members

  • For Providers

  • For Employers

Member FAQ

    • Q: What is the difference between EAP and Behavioral Health benefits?
    • A: Employee Assistance Program (“EAP”) is services provided by an employer that is free of charge to its employees and often their family members. EAP visits are confidential sessions for non-clinical problems, i.e. grief, anger management, financial and marital counseling. These sessions are limited; normally about 3-6 sessions as defined by the employer and are solution based, short term therapy. Behavioral Health Care is a service for individuals with specific diagnoses such as clinical depression, bipolar disorder, etc. Substance abuse treatment benefits also fall under this category. Unlike EAP sessions, there is normally a copayment for these services that is designed by the employer.
    • Q: Do I need to get pre-authorization?
    • A: Pre-authorization is required prior to all EAP sessions; it is not required for most outpatient mental health and substance abuse services; if you prefer, you may call in advance to verify that the service you are seeking is covered and to allow us to send pre-authorization to the provider.
    • Q: What is covered under my Behavioral Health benefits?
    • A: Behavioral Health benefits cover clinical diagnoses such as depression, anxiety, ADD/ADHD, substance use disorders, bipolar disorder and other conditions.
    • Q: What is covered under my EAP benefits?
    • A: EAP covers basic counseling needs in the areas of marital/family conflicts, stress, grief, emotional issues and everyday life struggles as well as financial, legal and elder care services. Clinical Diagnoses are not covered under EAP benefits.
    • Q: What is the procedure for accessing my EAP benefits?
    • A: Call American Behavioral at 800-925-5327; we will assist you in locating an appropriate provider, or share a list of providers, if you prefer. We can make the initial appointment for you or you may make the appointment directly. Please note that an authorization must be made and sent to your provider prior to the initial session.
    • Q: What is my “allowed amount” under out-of-network benefits?
    • A: The allowed amount is based on pre-determined fee schedules and/or per diems whenever possible and may vary depending on the service rendered and/or area of the country. Call 800-677-4544 for more information.
    • Q: What is my copay for behavioral health care services?
    • A: Copays vary by employer plan; contact your employer’s Human Resources Department, check your company benefit plan or call 1.800.925.5327 to determine your copay amount.
    • Q: How do I get a wallet card?
    • A: Your Human Resources department can assist you with obtaining communication and benefit material.
    • Q: What is your address/fax number?
    • A: 2 Park Plaza Suite 1200 Irvine, CA 92614 Phone: 1.800.925.5327 Fax: 205.868.9600
    • Q: What are the different provider credentials?
    • A: EAP counselors are usually masters-prepared with designations such as LPC (Licensed Professional Counselor), LCSW (Licensed Clinical Social Worker), and LMFT (Licensed Marriage and Family Therapist). Behavioral Health Counselors may include the above masters-prepared counselors as well as PhD psychologists who perform psychological testing and therapy and MDs (psychiatrists who may prescribe medications).
    • Q: Is a provider allowed to charge the cost of the visit to me if I do not give adequate notice of cancellation?
    • A:
      Providers establish their own policies regarding collection of fees for lack of cancellation notification or inadequate cancellation notice. The member is responsible for any fee associated with the violation of a provider’s cancellation policy.
    • Q: What is American Behavioral?
    • A: American Behavioral Benefits Managers, Inc. (“American Behavioral”) is a full-service behavioral health care services organization providing Employee Assistance Program services, mental health care services, pre-employment and promotional psychological testing, drug screening, manager and supervisor training and critical-incident stress management to approximately 2million members throughout the United States.

Provider FAQ

    • Q: How do I contact Provider Relations?
    • A: Provider Relations: Toll Free: 1-877-660-6646 x404 Fax: 205-868-9600 or 205-868-9625 Email: providerrelations@americanbehavioral.com Address: 2 Park Plaza Suite 1200 Irvine, CA 92614
    • Q: What is the best way to update/add information about myself or my practice?
    • A: Providers are requested to complete a Change of Information form that can be emailed (providerrelations@americanbehavioral.com), mailed (2 Park Plaza Suite 1200 Irvine, CA 92614, ATTN: Provider Relations) or faxed (205-868-9600) to the Provider Relations Department for processing. Once the data is processed you will receive an email confirming the changes have been made. Click here to download the Change of Information form.
    • Q: How do I sign up for Direct Deposit?
    • A: Direct Deposit (via ACH) is reserved for providers who are currently credentialed on the American Behavioral panel of preferred providers. Direct Deposit is mandatory for all new providers. Providers currently not enrolled in Direct Deposit will be required to do so for all payments on or after January 1, 2014. To enroll, a Provider Direct Deposit Form must be filled out and MAILED to the Provider Relations Department (2 Park Plaza Suite 1200. Irvine, CA 92614, ATTN: Provider Relations) along with a voided check or deposit slip that shows both the routing number and bank account number of the account you wish funds to be deposited.  Click here to download the Provider Direct Deposit Form.
    • Q: How do I contact the Claims Department?
    • A: Claims Department: Toll Free: 1-877-660-6646 x696 Fax: 855-859-1699 Address: 2 Park Plaza Suite 1200 Irvine, CA 92614
    • Q: How do I bill for EAP claims?
    • A: EAP services are billed on a standard CMS 1500 Form and must be pre-authorized. Please DO NOT use a Diagnosis code, as EAP services cover non-clinical issues. Use “EAP” in both box 21 and box D. Alternatively, you can use the appropriate ICD 10 “Z” Code in box 21 on the CMS 1500 Form. Click the here for an example CMS 1500 with the required fields highlighted. At the end of the allotted number of EAP sessions, providers are asked to submit a Case Closure Form that notifies the EAP department of the progress of your member. This form can be faxed to 205-868-9600. Click the here to download the Case Closure form. American Behavioral EAP & Behavioral Health Care Claims Information Electronic Claims: Payor ID: 63103 Clearinghouse: Emdeon Paper Claims: 2 Park Plaza Suite 1200 Irvine, CA 92614 As one of our preferred providers, you can file claims, check claims status, check/ payment status, authorizations and your provider profile by logging on to the American Behavioral Provider Web Portal. Click here for instructions. Providers can register for access to the portal by clicking on the Provider Login page and clicking on First Time Users link. If you need assistance with the provider portal, you can reach our helpdesk at helpdesk@americanbehavioral.com or 1-800-925-5327 Ext.450.
    • Q: How do I bill for Behavioral Health Care and outpatient substance abuse claims?
    • A: Behavioral Health and outpatient substance abuse services are billed on a standard CMS 1500 Form.  Please use a clinical mental health care diagnosis code, as MBH benefits cover clinical issues.  Click here to see a CMS 1500 with the required fields highlighted.
    • Q: What do I do if I am currently seeing one of your members and I’m not on your panel?
    • A: Qualified eligible Providers and Facilities can be set up on a provisional basis to cover services that are rendered before they are credentialed with American Behavioral.  To request provisional status, please contact provider relations at 1-877-660-6646 x404 or providerrelations@americanbehavioral.com.
    • Q: How do I become a provider?
    • A: If you would like to join the American Behavioral Preferred Provider Network, our Provider Relations Department can forward credentialing materials via email, fax or regular mail at your request. You are encouraged call or email us at 1-877-660-6646 x404, or providerrelations@americanbehavioral.com. You can also use the “Join Our Network” link located on the main Provider’s page. We have a wide array of providers in our network, ranging from LPC, LMFT, LMHC, LCPC, PHD, PSYD, MD, DO, ARNP, CRNP and many other variations of mental health licensures. You are welcome to contact us in advance of submitting an application so as to ensure your license type is accepted. Below are the requirements for initial credentialing: In addition to a completed, signed and dated Participating Provider Application and Participating Provider Agreement, the following requirements/thresholds must be met by anyone wanting to qualify to join the network of providers working with American Behavioral: REQUIRED: 1. Current license, unencumbered, within the state where practice occurs. 2. Non-board certified physicians must be able to demonstrate successful completion of an appropriately approved residency training program. 3. Must have never been convicted of, or pled no contest to, any felony charge(s). 4. Cannot currently be under sanctions by Medicare or Medicaid. 5. Cannot currently be under discipline from any State Licensing board, County, State of Professional Society, other Professional Groups/Hospital Medical or Clinical Staff. 6. Psychologists must hold current license as a health service provider in psychology or be listed in the National Register of Health Services Providers in Psychology. ADDITIONAL CRITERIA: 1. Practitioners are required to carry general liability medical malpractice insurance of at least one million dollars per occurrence and three million dollars aggregate. Exceptions to these thresholds may be allowed only when specific state laws provide otherwise. 2. Practitioners must be free of physical or mental health conditions that affect, or would likely affect, one’s ability to perform professional duties appropriately. 3. Practitioners must have no unexplained chronological gaps in their recent professional career history. A gap is defined as 180 consecutive days or more. 4. Practitioners are required to be experienced and comfortable working with patients in a short term problem oriented structure and a maintenance treatment format with the understanding that personal growth issues are non-covered therapies. 5. Practitioners are expected to be able to provide proof of qualified supervision prior to licensure upon request.
    • Q: What is the best way to check on the status of my application?
    • A: Providers, Groups and Facilities are able to check the status of their application by simply emailing or calling our Credentialing Coordinator at 1-877-660-6646 x899 or via email at providerrelations@americanbehavioral.com. American Behavioral’s credentialing committee meets on a regular basis, normally monthly to evaluate the canidates requesting credentialed provider status. Applications are processed in the order in which they are received, with more emphasis placed on those applications filed with complete supporting requested documentation. The speed with which an application is approved varies dependent upon the volume of applications received during any given credentialing cycle. We normally estimate a 6-8 week timeframe before an application is approved by the credentialing committee. However, special provisions may be made for providers who are not credentialed with American Behavioral but are currently seeing our members.
    • Q: How can I check a claims status?
    • A: The quickest way to verify the status of the claim is through the Provider Web Portal.  Alternatively you can call 1-877-660-6646 or email info@americanbehavioral.com to check claims status.
    • Q: Information regarding CEUs and CMEs
    • A:


      AMERICAN BEHAVIORAL OFFERS DISCOUNTS ON ON-LINE CONTINUING EDUCATION PRODUCTS American Behavioral is proud to be affiliated with two premier on-line providers of continuing education units who have agreed to offer discounted CEUs for the American Behavioral network of providers. It is important to check with your individual state licensing board for acceptance of this accredited agency to ensure that you get appropriate credit for the training. PSYCHCEU.com Offering a 20% discount Offers a variety of continuing education programs that have been approved by APA, APT, BRN, NAADAC, NASW, NBCC, and others. See their website for a complete listing; a sampling of approved agencies include:
      • American Psychological Association
      • National Board for Certified Counselors (NBCC)
      • National Association of Social Workers
      • The Association for Play Therapy
      • Board of Registered Nursing
      • NAADAC-The Association for Addiction Professionals
      You may take your post test online and receive your certificate immediately. To obtain a 20% discount on the courses, go to www.psychceu.com and be sure to use the case-sensitive American Behavioral discount code: BEHAVIORAL 09 SPEEDYCEUs Offering a 10% discount Offers courses approved by The National Association of Social Workers (NASW), National Board for Certified Counselors (NBCC), California Board of Behavioral Sciences, California Board of Registered Nursing (Recognized by all State Boards except Delaware), Florida CSW’s, MFT’s and MHC’s, Texas Social Workers, LMFT’s and LPC’s. To obtain a 10% discount on the courses, go to www.speedyceus.com and use the American Behavioral discount code: ceus


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Employer FAQ

    • Q: How do I obtain information about providers?
    • A: For a provider listing or assistance with scheduling an appointment, click here or call 800.925.5327. For additional provider information and/or network coverage information, contact our provider relations department by emailing prdocs@americanbehavioral.
    • Q: Who do I contact if I need communication materials (wallet cards, fliers, posters, etc)?
    • A: For new or additional communication materials, contact your Account Manager for more assistance.
    • Q: What’s the process for making a management referral to the EAP?
    • A: To initiate a Formal Management Referral, please contact us at 1-800-925-5327. You can also refer to the Formal Management Referral Guide for more information.
    • Q: How can I obtain information about my EAP services?
    • A: If you need information about your EAP benefit services or to make an appointment with a counselor, contact our Central Intake Department at 1-800-925-5327. Should you wish to discuss upgrading your EAP plan services, contact your account manager for assistance.
    • Q: Who should I contact about obtaining information regarding on-site and webinar training courses?
    • A: For additional information or to schedule an on-site or webinar training program, please contact your Account Manager for more assistance.
    • Q: Who should I contact for information regarding health fair participation or wellness initiatives?
    • A: To make a request for an American Behavioral representative to attend your health fair or for assistance with wellness initiatives, please contact your Account Manager for more assistance
    • Q: What is the process for obtaining information regarding an employee’s claim?
    • A: Questions regarding employee’s claims should be directed to the Claims Department at 1-877-660-6646 x696 or info@americanbehavioral.com.
    • Q: Who do I contact if I have questions about an invoice or are in need of a Form 5500?
    • A: Questions regarding client invoices or requests for Form 5500’s should be directed to Tammi Dean, Director of Finance and Corporate Controller, at tdean@americanbehavioral.com or 205-868-9608.
    • Q: How do I access Personal Advantage if I forgot/misplaced my log-in information?
    • A: Click on the “recover password” link in the Personal Advantage sign-in box. After correctly answering a security question, your password will be automatically reset. If this does not solve the problem contact your Account Manager for more assistance.
    • Q: What is the process for requesting assistance with a critical incident?
    • A: If you have experienced a critical incident, immediately contact us during normal business hours at 800-925-5327. If you have experienced a critical incident after business hours, immediately contact 1-800-925-5327.
    • Q: Who can assist me with developing company policies regarding EAP, Behavioral Health, or Substance Abuse policies?
    • A: For information in developing EAP/Behavioral Health or Substance Abuse policies for your company contact your Account Manager for more assistance.