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Your Behavioral Health Insurance Plan
About Your Behavioral Health Insurance Plan
PacifiCare Behavioral Health (PBH), the nation's most clinically advanced behavioral health care organization, offers insurance benefits that cover behavioral health care, provided by your LANL health insurance carrier. PBH provides a full spectrum of mental health services, chemical dependency rehabilitation, and detoxification programs.
In addition, it offers employee assistance programs and extensive work/life benefits, including those targeted at disease management.
Eligibility
Any employee enrolled in either United Healthcare’s Select EPO, an Options PPO, or the Definity insurance plan is eligible for PBH benefits.
Cost
Your co-payments are $15 per visit for Select EPO, Options PPO New Mexico and Definity. There is a $250 deductible per person, per calendar year for Options PPO National and Out-of-Area.
Search for Services
- Go to PacifiCare Behavorial Health web page.
- Click on Members.
- Click on Provider Directory on upper right toolbar.
- Click on Complete Providers Directory.
- Input your search criteria and click on get results.
- You must first call PacifiCare Behavioral Health (PBH) for an authorization prior to your first counseling visit. If you do not get authorization, you will be responsible for the cost of the visit. It will not be paid for by PBH if this is a requirement for your plan. If you are unsure whether or not you need an authorization, it's better to call PBH.
Requesting Services without Search
- You (or your eligible family member) request the service(s) by calling PBH Member Services at 1-800-817-8811.
- A PBH associate collects your demographic data and verifies eligibility.
- A PBH clinical interviewer conducts a brief assessment then matches you with a qualified PBH provider.
- You (or your eligible family member) schedule an appointment with the referred PBH provider.
- PBH notifies the provider of the referral and authorized service(s).
- You (or your eligible family member) have now been authorized by PBH for the requested service(s).
On-going Therapy
If you are currently seeing a therapist, you have two options for remaining with that provider:
- When your current therapist is already a PBH provider, you may be able to continue to see that therapist. You are still considered a PBH patient and will need to qualify for therapy. Preauthorization of any service(s) will need to be obtained by following the process, above, for requesting services. The clinical interviewer conducting the assessment may authorize treatment to continue with your therapist for a specified number of visits or may refer you to another specialist.
- When your therapist is not a PBH provider, you can choose between continuing with your current provider or being referred to a PBH provider. If you choose to remain with your current provider, you will pay the full cost of that provider's charges.
Benefits Program Summaries
The PBH Web site contains a wealth of information, including a library of self-help articles and more details about its programs. You can also call PBH Customer Service at their toll-free number: 1-800-999-9585.
Questions? Contact the Lab's Benefits Office at 505-667-1806.
