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EAP Billing

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melissa_2004:
Does anyone currently bill EAP?  Specifically billing an EAP company known as Bensinger Dupont & Associates?  Looking for tips and pointers.

Thanks...

PMRNC:
EAP works differently with each one. It's an "additional" benefit. One pointer for ALL EAP's is to make absolutely certain you keep a separate file for EAP visits, the reasoning behind it is that it's a complete and separate benefit employers give employees and is STRICTLY confidential. Even the Major Med carrier will not be able to give you information on EAP's, eligibility, etc because one does not know about the other. 99% of the time there are no copay's or coinsurance. EAP's usually have a max per incident OR per patient/annually. Again, they are all different, best to get the guidelines for filing and authorizations via the EAP carrier.

melissa_2004:
Thanks Linda...

Jdmontee:
I bill lots of EAP's as we provider mental health billing.  EAP's are always a seperate entity from other services.  They will require a seperate auth so as Linda stated you must track the EAP seperately.  Also, Cigna Behavioral EAP's are billed using a 99404 proceedure code otherwise they will process as a normal mental health visit.  Alot of carriers require the provider to close out the EAP case with the insurance company once EAP is complete.

Just some other tips!

Joannd

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