Assignment of Benefits for Non-Network MHSA Services

Beacon Health Options (Beacon) is the administrator for The Empire Plan’s Mental Health and Substance Abuse Program (MHSA).  Until recently, the Empire Plan prohibited claim payments for non-network MHSA from being sent directly to a provider.  All non-network claim payments were paid directly to the member and the member was required to send payment to the provider of service.  This resulted in numerous problems for enrollees and providers of service.  The NYS Department of Civil Service recently reviewed and revised this policy and will allow assignment of benefits to non-network MHSA claims processed on or after March 1, 2018.  Beacon Health sent a letter explaining this change to enrollees who obtained services under the non-network portion of the MHSA Program.

 

If you have already paid a non-network provider for a date of service and have not submitted a claim form to Beacon yet, do not indicate an assignment of benefits on the claim form. This will result in the provider being paid twice for the same date of service. If this does occur it will be your responsibility to recoup money owed to you from the non-network provider.

 

By receiving MHSA Program services from a non-network provider your out-of-pocket costs are much higher.  If you have any questions or would like to discuss transitioning to a network provider, please contact Beacon’s Customer Service at 1-877-7-NYSHIP (877-769-7447), Option 3 between 8 AM and 8 PM (EST).