American Behavioral

Employee Assistance Program

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Auburn University's Employee Assistance Program is administered through American Behavioral and is available to all benefit-eligible employees with up to three free visits per year.

An EAP program is a confidential assessment, counseling, and referral service for all regular employees and their eligible dependents who need help with: marital and family issues; alcohol and other drug dependency; stress-related issues; financial/legal referrals; and emotional problems.

The EAP counselor can help identify problems and assist in working through them. The counselor can also determine the best alternatives and, if necessary, make appropriate referrals to other professionals who specialize in particular areas. The program is:

  • Confidential: All information is kept strictly between the individual and the counselor.

  • Informal: A simple phone call starts the process.

  • Free: All counseling offered within the EAP is provided as a benefit by Auburn University.

For additional information, call (800) 925-5EAP (5327).

Mental Health and Substance Abuse Treatment

Mental health and substance abuse treatment are available only to employees, dependents, and retirees covered under the Auburn Medical Plan.  For more information, call (800) 925-5EAP (5327)

Inpatient
  • Number of days determined by medical necessity

  • Co-pay same as medical plan

Outpatient
  • Number of visits determined by medical necessity

  • Co-pay same as medical plan 

Summary of Mental Health and Substance Abuse Benefits for Auburn University

Printable version

Effective January 1, 2018
Summary Document #: 277507868429

Important Information: All benefits are based on the appropriate level of care and medical necessity guidelines. Provider/facility licensure by the state to provide covered services and facility accreditation by The Joint Commission or CARF is required.

Calendar Year Deductible: $250 Per Person Per Year With a Three (3) Member Family Maximum

Calendar Year Out-of-Pocket Maximum: $7,350 Individual / $14,700 Aggregate Family Maximum

In-Network Out-of-Network
Inpatient Hospital Facility Services
  • Acute Inpatient Hospitalization

  • Inpatient Electroconvulsive Therapy (ECT)

  • Partial Hospitalization/Day Treatment (PHP)

  • Intensive Outpatient Program (IOP)


  • PHP: Two (2) PHP days equal one (1) inpatient day

  • IOP: Two (2) IOP days equal one (1) inpatient day

Pre-admission certification required; Call 800-677-4544

  • Up to 30 days total for inpatient care (mental health and substance abuse treatment) each 12 consecutive months

  • Covered at 100 percent of allowed amount after copay, subject to calendar year deductible

  • Patient Responsibility: $200 copay per admission subject to calendar year deductible

Pre-admission certification required; Call 800-677-4544

  • Up to 30 days total for inpatient care (mental health and substance abuse treatment) each 12 consecutive months

  • Covered at 80 percent of allowed amount subject to calendar year deductible

  • Patient Responsibility: 20 percent of the allowed amount subject to calendar year deductible and all billed charges not covered by the Plan

Substance abuse program including:

  • Detoxification

  • Rehabilitation

  • PHP


  • Treatment applies to inpatient hospital services

  • Substance abuse treatment = once per lifetime

Pre-admission certification required; Call 800-677-4544

  • Up to 30 days total for inpatient care (mental health and substance abuse treatment) each 12 consecutive months

  • Covered at 100 percent of allowed amount after copay, subject to calendar year deductible

  • Patient Responsibility: $200 copay per admission subject to calendar year deductible

No Out-of-Network Benefit
Professional Services
  • Outpatient office visits

  • Ambulatory detoxification

  • Up to 30 visits/sessions/group therapy sessions (or any combination thereof) total for outpatient care (mental health and substance abuse treatment) per member per calendar year

  • Covered at 100 percent of allowed amount after copay

  • Patient Responsibility: $30 copay per visit/session/group therapy session

  • Up to 30 visits/sessions/group therapy sessions (or any combination thereof) total for outpatient care (mental health and substance abuse treatment) per member per calendar year

  • Covered at 80 percent of allowed amount

  • Patient responsibility: 20 percent of the allowed amount and all billed charges not covered by the Plan

Psychological/Neuropsychological
testing

Pre-admission certification required; Call 800-677-4544

  • Limited to five (5) hours of psychological/neuropsychological testing per member per calendar year

  • Covered at 100 percent of allowed amount after copay

  • Patient Responsibility: $30 copay per hour

Pre-admission certification required; Call 800-677-4544

  • Limited to five (5) hours of psychological/neuropsychological testing per member per calendar year

  • Covered at 80 percent of allowed amount

  • Patient responsibility: 20 percent of the allowed amount and all billed charges not covered by the Plan

Applied Behavior Analysis (ABA) for the treatment of Autism Spectrum Disorders

Based on eligibility and clinical criteria being met

Pre-admission certification required; Call 800-677-4544

  • Ages 0-9: Up to $20,000 per child per calendar year

  • Ages 10-13: Up to $15,000 per child per calendar year

  • Ages 14-18: Up to $10,000 per child per calendar year

No Out-of-Network Benefit

Inpatient physician services in conjunction with approved inpatient services
  • Up to 30 days total For inpatient care (mental health and substance abuse treatment) each 12 consecutive months

  • Covered at 100 percent of allowed amount

  • Patient responsibility: None

  • Up to 30 days total For inpatient care (mental health) each 12 consecutive months
  • Covered at 80 percent of allowed amount

  • Patient responsibility: 20% of the allowed amount and all billed charges not covered by the plan

Anesthesia in conjunction with approved ECT treatment
  • Covered at 100 percent of allowed amount subject to the inpatient copay amount

  • Patient responsibility: None

  • Covered at 80 percent of allowed amount

  • Patient responsibility: 20% of the allowed amount and all billed charges not covered by the plan

Covered by Medical Plan
  • Ambulance

  • Emergency department

  • Imaging

  • Lab work

Covered by the Auburn University Medical Plan through BCBSAL Covered by the Auburn University Medical Plan through BCBSAL
Behavioral Health Care Management
Care management is a service offered by the Plan to assist you with difficult behavioral health care needs. You have a personal care manager who acts as your advocate, assisting you whenever you have questions or concerns. Call American Behavioral at 800-677-4544 to talk to your personal care manager.

Transition of Care

Printable version and Provider Nomination/Addition Form

For transition of care, American Behavioral offers one to three visits based on the intensity of services and the severity of the patient’s illness for those individuals currently receiving clinical behavioral healthcare treatment. Please assist American Behavioral in easing transition of care for you or your family members by doing the following:

  • Have your current providers direct all requests for inpatient, partial hospitalization and intensive outpatient reviews to American Behavioral. These requests should be directed to case management prior to the organization’s termination date.  Any facility-based admissions will be covered and managed by American Behavioral upon the effective date of your contract with American Behavioral.

  • Attached please find a copy of the Provider Nomination Form. This is important, even for those not currently receiving services, as American Behavioral uses the completed forms in an effort to create a personalized provider network for the University. Fax or mail completed forms to the number or address listed on the form.

  • Outpatient visits require an authorization. Please contact American Behavioral via the telephone numbers on the form.

  • If you see a primary care physician with a behavioral health diagnosis, and have the claim denied by Blue Cross Blue Shield; a Behavioral Health Reimbursement Form may be submitted to American Behavioral for payment. At that time, you will be offered the opportunity to schedule an appointment with an in-network provider.

Last updated: 05/18/2018