How it works
Anthem Bank of America EAP clients will be able to schedule directly, based on your availability, after entering their member EAP information (i.e., MRN number).
In your calendar view, you will see “EAP session” on the booking to notify you if a client has scheduled under this plan.
Clients can be seen through their Anthem EAP benefits for 12 sessions at no cost to the client. Please note that phone consultations do not count toward these 12 sessions.
After these 12 sessions, you can continue care with the client through their primary insurance on Headway. You'll need to be credentialed with their primary insurance (if it’s not Anthem) to continue sessions once the EAP has been used.
Provider type restrictions
For Anthem Bank of America EAP, only clinical psychologists & master level therapists can accept this EAP. All other provider types cannot accept Anthem Bank of America EAP.
Billing for Anthem Bank of America EAP sessions
When billing for EAPs, you will confirm the session as you normally would. However, there are some restrictions on which CPT codes are available for EAP sessions (see below).
After all EAP sessions are used, the client’s regular insurance benefits will process automatically.
Please note that even while a client is under an EAP, we require a payment method on file to submit appointments, in the event of a late cancellation (not covered by insurance).
CPT codes available
The following code is allowed by Anthem for EAP sessions:
- 99404
Any EAP visit coded with any code other than 99404 will be billed through the client’s regular insurance.
These sessions are expected to last a therapeutic hour, which is considered to be 45-50 minutes of face-to-face or telehealth care.
Rates
You can view rates for this plan, and the EAP session CPT code on your Rates page. Payments for these sessions will be paid to you as part of your usual bi-weekly payments from Headway; there are no additional administrative requirements for you to receive payment for these sessions.
Cancellation and no-show fees
You are not able to bill a cancellation fee for no shows or cancellations for sessions covered by Anthem EAP benefits. These additional fees cannot be charged on or off of the Headway platform.
Opting out
You’ll automatically be eligible to see Bank of America clients that have Anthem EAP benefits. If you don’t wish to accept Anthem EAPs through Headway, let us know.
Provider acknowledgement
For more information on confidentiality, participation, referral, fees, and services not covered, visit the Anthem EAP Statement of Understanding.
The following services are not part of Anthem Bank of America EAP benefits:
- Court ordered treatment
- Psychological, Neuropsychological, and Forensic testing
- Psychiatry and/or medication management services
- Group therapy
- Inpatient services
- Partial Hospitalization services
- Intensive Outpatient services
- Evaluations or reports for a legal proceeding
- Authorizations for leave of absence or time off from the workplace
- Specialized treatment or evaluations required as a condition of parole, probation, or custody
- Forensic evaluations
- Determinations or reports related to Family Medical Leave Act or Short/Long Term Disability
- Expenses related to Substance Abuse Professional (SAP) services
- Fitness-For-Duty services