Mental Health and Chemical Dependency Benefits

Claims incurred prior to January 1, 2012 - OptumHealth will continue to process all claims, including claim appeals for services rendered during this period and such claims should be submitted directly to OptumHealth. Claims will be honored through the Plan's filing period of 2 years or December 31, 2013.

Claims incurred prior to January 1, 2012 - Mental health and chemical dependency benefits are administered by OptumHealth Behavioral Solutions. Providers should electronically submit their claims directly to OptumHealth Behavioral Solutions. If you are filing your own claim, you must submit your claim directly to OptumHealth Behavioral Solutions, using an HCFA 1500 Form. It is recommended that you retain copies of the claims you are submitting.

The claim form should include the following information:

• Participant's Name
• Participant's Health Fund ID Number (as it appears on the Health Fund ID Card)
• Provider's Name
• Provider's Address
• Provider's Federal Tax ID Number
• Patient's Name
• Patient's Date of Birth
• Procedure CodeAlso referred to as CPT (Current Procedural Terminology) codes, are numbers or alphanumeric codes assigned to every task and service a medical practitioner may provide to a patient including medical, surgical and diagnostic services. They are then used by insurers to determine the amount of reimbursement that a practitioner will receive by an insurer. Since everyone uses the same codes to mean the same thing, they ensure uniformity. (provided by doctor on bill)
• Diagnosis CodeA three to five digit code representation of the identification by a medical provider of a condition, disease or injury made by evaluating the symptoms and signs presented by a patient. (provided by doctor on bill)
• Amount Paid (if any)

For Claims incurred prior to January 1, 2012 submit to the following address:

P.O. Box 31053
Laguna Hills, CA 92654-1053

To reach the Customer Service Unit, call (888) 301-0056.