The PHCS Network operates through MultiPlan, Inc. It provides members with one of the nation’s largest Preferred Provider Organizations. Through the PHCS Network, members have access to nearly 4,400 hospitals, 79,000 ancillaries, and more than 700,000 healthcare professionals for services including drug and alcohol detox, addiction treatment, mental health treatment, and other essential healthcare services.

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 coverage 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 so members can feel assured they are choosing their healthcare provider from a high-quality network.

Is PHCS/MultiPlan Insurance?

No, PHCS/MultiPlan is not health insurance, a health plan provider, or an insurance carrier and, therefore cannot answer questions regarding drug and alcohol detox services or addiction treatment services under your current health plan. However, what PHCS/MultiPlan can do is provide its members with additional choices in providers that can offer discounts on addiction treatment services/substance abuse services. PHCS/MultiPlan health insurance services involve strategies for members to reduce their cost of healthcare.

How Do I Find a New Doctor, Treatment Facility, or Treatment Team in My Network?

You can find a doctor or treatment facility within your PHCS network on the MultiPlan website. If your current doctor is not listed on their site, you can nominate new doctors or treatment centers (including residential treatment centers).

Addiction Resources with PHCS

PHCS insurance coverage works alongside many major health insurance companies to provide the most forward-thinking addiction treatment 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 member’s case and ensure they are in the right level of care and with the right direct health insurance 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 through their health insurance plan.

Does PHCS Cover Out-of-Network Addiction Treatment?

Unfortunately, PHCS does not cover out-of-network addiction treatment. It is the member’s responsibility to confirm that the provider or facility participates in the PHCS Network and that they have coverage under their benefits 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 (including substance abuse treatment and drug and alcohol detox treatment). To determine your addiction treatment coverage, contact the PHCS member services department.

Inpatient Treatment with PHCS Coverage

Each PHCS plan is written specifically by the insurance company or employer to meet the member’s needs. Some PHCS plans might not cover the 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/Mental Health Services
  • Individual Therapies
  • Medical Examination and Treatment
  • Detoxification
  • Inpatient Rehab Stay
  • Aftercare Services

We can help you navigate your PHCS coverage to see if your plan covers inpatient treatment services for one or more of the below:

For help navigating your Inpatient Treatment Coverage, contact our rehab advisors. We are here to help you maximize your plan’s benefits and minimize your out-of-cost expenses.

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 likely have a copayment amount that will apply to the member’s 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 PHCS member services. For help finding a reputable drug or alcohol treatment center near you, contact us.