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MCOs - Managed Care Organizations
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How to Contact the top 15 Managed Care Companies

Here is a list of the largest MCO’s in the nation. The reimbursment rates among these companies varies so you may want to inquire about fees for service when you call. Covered lives is in parentheses.

Magellan Behavioral Health (69)
7188 Columbia Gateway Drive
Columbia, MD 21406
800-735-4005
www.magellanhealth.com

Value Options (22)
P.O. Box 4050
Virginia Beach, VA 23454
800-397-1630
www.valueoptions.com

United Behavioral Health (20)
425 Market Street, 27th Floor
San Francisco, CA 94105
800-533-8724
unitedbehavioralhealth.com

Cigna Behavioral Health (12)
61095 Viking Drive, Ste. 850
Eden Prairie, MN 55344
800-554-6931 or 800-926-2273
CignaforHCP.com

Managed Health Network (10)
1600 Los Gamos Drive, Ste. 300
San Rafael, CA 94903
800-541-3553
www.mhn.com

American Psych Services (APS) (7)
5705 Rockledge Road, Ste. 200
Bethesda, MD 20817
800-752-7242
www.apscare.com

First Mental Health (4)
501 Great Circle Road. Ste. 300
Nashville, TN 37228
800-593-6462

Com Psych (4)
455 North Cityfront Plaza, Floor 24
Chicago, IL 60611
800-557-1005, ext. 4125
www.compsych.com

Family Enterprise (FEI) (4)
11700 West Lake Park Drive
Milwaukee, WI 53224
414-359-1040, ext. 8691
www.feinet.com

PacifiCare Behavioral Health (4)
23048 Avenue de la Carleta, Suite 700
Laguna Hills, CA 92653
800-718-1188
www.pbhi.com

Integra (3)
1060 First Avenue, Ste. 400
King of Prussia, PA 19406
800-282-1540
www.integra-ease.com

Wellpoint Behavioral Health (3)
9655 Granite Ridge Drive, 6th floor
San Diego, CA 92123
800-725-9498
www.wellpointbehavioral.com

Ceridian Performance Partners (3)
8100 34th Ave South
Minneapolis, MN 55425
952-853-8100
www.ceridianperformance.com

Horizon Behavioral Services (3)
One Valley Square
512 Township line Road
Blue Bell, PA 19422
800-223-7050
www.horizoncare.net

VMC Behavioral Health Care (2)
100 South Greenleaf
Gurnee, IL 60031
800-843-1327 or 847-249-1900

Other Insurers to Contact

Mamsi
800-469-8470

Blue Cross Blue Shield of N.C.
919-461-5246

Cameron and Associates
6100 Lake Forest Drive, Ste. 550
Atlanta, GA 30328
800-334-6014

Provider Relations
404-845-3730

Sobel and Raciti EAP
One Richmond Square
Providence, RI 02906
800-227-2195

InRoads EAP
325 North Fifth Street
Reading, PA 19601
800-432-7011


What are Managed Care Companies (MCO’s)?

Managed care companies are businesses that authorize and manage the disbursement of health and mental health services. Since 1985, MCO’s have developed a strong presence within the health care field. Their value was most evident in the early 1990’s when they successfully reduced the then spiraling health care costs.

One way MCO’s were able to curtail spiraling costs was by contracting with providers at reduced rates with the opportunity to receive a higher volume of referrals. This created what the industry calls Preferred Provider Organization (PPO).  In order to be on an MCO’s PPO list, a provider must apply, complete the credentialing process and be accepted. The process takes between 4-8 months.

Advantages of being on Preferred Provider Panels
1) Clients referred directly to you
2) May reduce need for marketing
3) Greater client flow

Disadvantages of being on Preferred Provider Panels
1) More paperwork
2) Less reimbursement
3) Need to file insurance
4) Need to reauthorize after set number of sessions


Options to Managed Care and Preferred Provider Panels (PPO’s)

1) See the client, using their "Out of Network" option
Many insurance plans currently offer an “out of network” option which allows for the client to see any therapist of their choosing, but their out of pocket co-pay will be higher. The difference may be as little as $20.00 more per session for the client; if the client has been referred to you as result of your marketing, he/she may likely pay the difference for your services.

2) See clients on a "cash only" basis
Many therapists have successfully transitioned to this type of business, and for obvious reasons: It results in direct and full payment to the therapist at the time of service. A therapist in this type of business may take full payment for services, and the client may choose to file with their insurance carrier for reimbursement.

 

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