Does Beacon Health Pay Out Of Network Benefits?

by | Last updated on January 24, 2024

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If Beacon Health Options receives a claim for emergency services from an out-of-network provider,

we'll pay the claim at the amount we determine to be reasonable for the emergency services

— except for any in-network cost-sharing (in-network copay, coinsurance and/or deductible) that applies under your plan.

What is the difference between Beacon Health Options and Beacon Health Strategies?

BOSTON – Jan. 5, 2015 – Beacon Health Strategies and ValueOptions®, today announced the completion of their merger.

The combined company is known as Beacon Health Options

and serves 45 million people across all 50 states and the United Kingdom, making it the premier managed behavioral health care company.

Is Beacon part of MassHealth?


All MassHealth (MH) members' behavioral health will be covered by Beacon

(Fallon or BMC HeathNet; NHP in Merrimack Valley only), Health New England (in Hampden County only), MBHP, or Tufts Health Public Plans.

Is Beacon Health owned by Anthem?

Anthem completed its acquisition of Beacon Health Options, a large behavioral health organization that serves more than 36 million people across the country.

The company will operate as a wholly owned subsidiary of Anthem

.

Does medical cover out of network?

Out-of-network means that a doctor or physician does not have a contract with your plan provider. This can sometimes result in higher prices.

Some health plans, such as an HMO plan, will not cover care from out-of-network providers at all, except in an emergency

.

How do I get out of network claims paid?

2

Call the hospital or provider's billing department, tell them your bills are unaffordable, and ask if they can reduce the bill to a level you can afford

. If not, ask them to put you on a payment plan.

Who owns Beacon health options?

Parent organizations

What is Beacon Health Options of California?

Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

Is Beacon health the same as value options?


ValueOptions, Inc is now Beacon Health Options, Inc

. Members will start seeing the Beacon Health Options name incorporated into communications as the brand transition takes effect. Beacon Health Options provides the same services we did under our former name, ValueOptions.

Who is anthem merging with?

27 /PRNewswire-FirstCall/ — Anthem, Inc. (NYSE: ATH) and

WellPoint Health Networks Inc.

(NYSE: WLP), today announced that they have signed a definitive merger agreement that will create the nation's leading health benefits company.

What is the difference between in network and out of network?

When a doctor, hospital or other provider accepts your health insurance plan we say they're in network. We also call them participating providers.

When you go to a doctor or provider who doesn't take your plan, we say they're out of network.

What's the advantage of going to an in network provider?


In-network doctors and facilities have agreed not to charge you more than the agreed-upon cost

. Your share of costs is different—and usually higher. A copay is the amount you pay for covered health services at the time you receive care. There are no copays when you use a doctor or facility that is out-of-network.

Does out of network count towards deductible Unitedhealthcare?


Your premium and any out-of-network costs don't count toward your out-of-pocket maximum

. Once your deductible and coinsurance payments reach the amount of your out-of-pocket limit, your plan will pay 100% of allowed amounts for covered services the remainder of the plan year.

How does out of pocket maximum work for out-of-network?

Your in-network out-of-pocket maximum

includes all deductibles, coinsurance and copayments for in-network care and services

. Similarly, out-of-network expenses count towards your out-of-network OOPM. All services, healthcare providers and facilities must be covered under the plan for expenses to count toward the OOPM.

Are EPO and PPO the same?

EPO or Exclusive Provider Organization


Usually, the EPO network is the same as the PPO in terms of doctors and hospitals

but you should still double-check your doctors/hospitals with the new Covered California plans since all bets are off when it comes to networks in the new world of health insurance.

What is in-network provider in medical billing?

An in-network provider is

a healthcare provider or hospital that has signed a contract with your insurance company, agreeing to accept the insurer's discounted rates

.

What is the difference between mental and behavioral health?

While

behavioral health refers to how behaviors impact an individual's well-being, mental health is primarily concerned with the individual's state of being

.

Is Beacon health Options Kaiser?


In collaboration with Kaiser Permanente

, Beacon provides an alternative resource for outpatient mental health services for Kaiser Permanente members in the Southern California region.

What kind of company is Beacon?

Type Subsidiary Industry

health insurance
Headquarters Boston, Massachusetts Area served United States Key people Russel C. Petrella(Chief Executive Officer)

What is Beacon partnership?

​PHC has partnered with Beacon Health Options (Beacon) to

help manage mental health benefits for PHC Medi-Cal Members with mild to moderate mental health conditions in need of outpatient mental health services

. Calls related to outpatient mental health services can be connected to Beacon at (855) 765-9703.

James Park
Author
James Park
Dr. James Park is a medical doctor and health expert with a focus on disease prevention and wellness. He has written several publications on nutrition and fitness, and has been featured in various health magazines. Dr. Park's evidence-based approach to health will help you make informed decisions about your well-being.