Resilience and Well-Being

Carolina Behavioral Health Alliance, LLC coordinates Atrium Health teammate coverage for mental health and substance abuse services.

Atrium Health Teammate Coverage for Mental Health and Substance Abuse Services

In order to receive benefits for non-emergency care, you must receive advance certification by calling CBHA at 1-800-475-7900 and you must use a CBHA provider. Search for CBHA network providers.

About CBHA

As a provider-owned managed behavioral health organization, CBHA values our provider network as one of our most valuable assets. CBHA is proud of the collaborative relationships we have with our network and CBHA is always open to feedback from our Providers as we strive to improve our policies, programs and processes. CBHA reviews and updates the Provider Manual annually and makes available the updated version on its website every January. CBHA also communicates with our Provider Network via of Provider Newsletter.

Part of our commitment to quality is maintaining a comprehensive network of providers and facilities for our enrollees. Based on the 2008 Provider Satisfaction Survey results, 96% of contracted providers were satisfied with participation on the CBHA provider panel. CBHA maintains a network of over 1400 individual providers and more than 40 facility-based providers throughout North Carolina. With such a complete panel of contracted providers, CBHA expects enrollees to receive outpatient treatment within a travel standard of 30 miles or 30 minutes. The accessibility travel standard for facility-based care is 45 miles or 45 minutes.

The Professional Relations department is responsible for network development, credentialing/re-credentialing, provider orientation, and monitoring provider compliance with CBHA’s policies and procedures. The Professional Relations department is also responsible for conducting site reviews and record audits in some practices to insure compliance with CBHA’s record keeping standards.

Network adequacy is measured against covered lives in each geographic area to determine that sufficient numbers of providers are available to meet the demand for services. Prior to joining the CBHA network, providers must be contracted and credentialed. Credentialing is handled by the CBHA Professional Relations department which performs primary source verification including education, licensure, board certification, malpractice liability coverage, DEA registration (if applicable), and National Practitioner Data Bank reports. After all primary source verification is complete, CBHA’s Behavioral Health Quality Improvement Committee (BQIC), whose membership is comprised of a cross-section of the provider network, is responsible for the final approval for credentialing. Any Provider questions or concerns should be directed to the CBHA Professional Relations Department by calling 1-800-475-7900 or emailing info@cbhallc.com.

Mental Health Benefits Information from the Health Plan Summary Plan Document

• Mental Health and Substance Use Disorders Services Note: Requires precertification by CBHA. See Appendix A for details. For the Health Savings Plan and the Co-Pay Plan, Inpatient and Outpatient facilities services are covered as follows:, Atrium Health Value Network 85% after deductible, Preferred Network 75% after deductible, Other In-Network & CBHA Non-Network Inpatient 70% after deductible and Out-of Network 50% after deductible. Outpatient Physician services are covered on the Health Savings Plan: Value Network 85% after deductible, Preferred Network 75% after deductible, Other In-Network & CBHA Non-Network 70% after deductible, and Out-of-Network 50% after deductible. Outpatient Physician services are covered on the Co-Pay Plan: Atrium Health Value Network $20 co-pay; Preferred Network $25 co-pay, In-Network $30 co-pay and and Out-of-Network 50% after deductible. Psychiatrists (M.D.), psychologists (Ph.D.) or Masters of Social Work (M.S.W.) may bill the plan directly. Other licensed mental health practitioners may be asked to file claims under the direction of these professionals, depending on credentialing guidelines.
• The Plan Participant should call Carolina Behavioral Health Alliance (CHBA) at (800) 475-7900 to receive certification for services for the treatment of mental health or substance use disorders. CBHA will ensure that all Plan Participants receive necessary and appropriate care while avoiding unnecessary expenses. Carolina Behavioral Health Alliance (CBHA) is a Third Party Administrator contracted by the Plan to administer and pay claims for mental health and substance use disorders benefits. CBHA is a network of mental health and substance use disorders providers including Licensed Professional Counselors (LPC), Licensed Psychologists (PhD), Licensed Psychological Associates (LPA), Licensed Clinical Social Workers (LCSW), Licensed fee-based Practicing Pastoral Counselors (CFBPPC) and Licensed Substance Use Disorders Counselors (LSUDC). When you call CBHA, a trained and licensed mental health or substance use disorders professional will answer your call. He or she will discuss your problem and make a referral for evaluation, counseling or treatment to a Network Provider. Referrals are based on your needs and the Provider’s availability and experience with your kind of problem.
• Family Therapy / Counseling Family Therapy/Counseling is considered an eligible expense when provided by a licensed mental health practitioner.

See Appendix A. Page 112-113