Employee Assistance Programs Overview

What is an EAP?

Employee assistance programs (EAPs) are a wellness benefit that is separate from someone’s primary health insurance plan. EAPs offer confidential, short-term engagement and support for employees around their mental health.

Why are EAPs important?

As a provider, accepting EAP visits increases your exposure to clients seeking immediate mental health support and can help you to build your practice more quickly. Optum EAP visits are reimbursed at the same contracted rates as traditional in-network care.

After your clients’ EAP benefits have been used, you and your clients can continue care using their primary health insurance or out-of-pocket payments for further sessions. You can find a list of network partners currently in-network with Alma’s insurance program here: Network Partners and Geographies. 

Clients and their families, can use EAP benefits for short-term clinical interventions without paying a copay, coinsurance, or deductible.

For clients who don’t have access to health insurance or who are paying down a high deductible before they can access their full health plan benefits, EAPs can provide a way to quickly receive affordable care. EAP visits are covered entirely, with no copay, coinsurance, or deductible.

Current clients who have Optum EAP benefits and see an Alma provider (either out-of-pocket or in-network with Alma’s insurance program) can still apply their EAP benefits to between 3 and 10 sessions, depending on their benefit. 

How can I accept EAP benefits through Alma?

All providers who are already credentialed with Optum through Alma are eligible to take Optum EAP clients and file claims. 

How much can I get paid for Optum EAP sessions?

Alma’s reimbursement rates for Optum EAP visits are the same as those for traditional Optum health plan sessions. These rates are determined by four factors: Alma’s contracts with Optum, provider degree type, state, and services offered during each visit.

What if I’m not interested in EAPs right now?

You can choose to opt in or out of any of Alma’s insurance partnerships at any time! If you opt out of EAP benefits, your profile will not appear in search results for EAP in the Alma directory, and you will not be listed in Optum’s directory of EAP providers.

Will EAP’s give employers access to my client’s protected health information?

EAPs do not give employers access to any medical information for your clients. While EAP benefits are sponsored by employers, you can see EAP clients completely confidentially.

Will I only get paid for client sessions once all of their EAP sessions have happened?

No, Alma pays providers for their primary health insurance visits and their EAP visits on the same timeline; within 2 weeks of when a claim was submitted.

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