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PCHS Insurance Rehab Coverage | Best Rehab Centers

Editor Dan Schimmel, LCSW, CAP
Created On

The PHCS Network operates through MultiPlan, Inc. It provides members with one of the nation’s largest Preferred Provider Organizations. PHCS Network members have access to nearly 4,400 hospitals, 79,000 ancillaries and more than 700,000 healthcare professionals.

PHCS negotiates discounts that result in significant cost savings when you visit in-network providers, helping to maximize your benefits. A PHCS logo on your health insurance card tells both you and your provider that a PHCS discount applies. MultiPlan applies rigorous criteria when credentialing providers for participation in the PHCS Network, members can feel assured they are choosing their healthcare provider from a high-quality network.

Addiction Resources with PHCS

PHCS works beside many major health insurance companies to provide the most forward thinking addiction resources to their members. With 24/7 crisis helplines and member services, members are able to get in contact with one of the thousands of healthcare professionals within the network to begin the treatment process to overcome their addiction.

PHCS’ clinical team works to review each members case and ensure they are in the right level of care and with the right provider. With a diligent care management team and utilization review department, members are ensured they will receive the care they need with the coverage they need to ensure they do not have any additional out of pocket expenses.

Does PHCS Cover Out-of-Network Addiction Treatment?

Unfortunately PHCS does not cover out-of-network addiction treatment. It is the members responsibility to confirm that the provider or facility participates in the PHCS Network and that they have coverage under their benefit plan.

When scheduling your appointment, specify that you have access to the PHCS Network through your insurance company and confirm the provider’s current participation in the PHCS Network.All providers are required to obtain preauthorization for addiction treatment services. To determine your addiction treatment coverage contact PHCS member services department.

Inpatient Treatment with PHCS Coverage

Each PHCS plan is written specifically by the insurance company or employer to meet the members needs. Some PHCS plans may not cover inpatient level of care. Those that are covered for this level of care are responsible for their member deductible and any copayment for inpatient services.

Commonly covered inpatient services by PHCS include:

  • Screenings and Assessments
  • Psychiatric Evaluations
  • Individual Therapies
  • Medical Examination and Treatment
  • Detoxification
  • Inpatient Rehab Stay
  • Aftercare Services

Outpatient Treatment with PHCS Coverage

Most PHCS plans have outpatient treatment coverage within the preferred provider network. Depending on the level of outpatient care received, prior authorization may be required. These services will most likely have a copayment amount which will apply to the members maximum out of pocket.

Commonly covered outpatient treatment services by PHCS include:

  • Partial Hospitalization (PHP)
  • Intensive Outpatient (IOP)
  • Individual Therapies
  • Group Therapies
  • Psychiatric Evaluations and Management
  • Screenings and Assessments
  • Medical Examinations and Treatment
  • Aftercare Services

To determine your outpatient treatment coverage and expected out of pocket expenses, contact member services.

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