A MultiPlan PPO network may be used for partial hospitalization (PHP) when the member’s underlying health plan covers PHP and the provider participates under the applicable network arrangement. Trinity Behavioral Health accepts MultiPlan network arrangements, but MultiPlan is a provider network, not the underlying insurer. The actual payer or administrator determines covered benefits, authorization, medical necessity, deductible, coinsurance, and claims rules.
Before admission, verify the underlying plan and MultiPlan network benefits.
Does MultiPlan determine whether PHP is covered?
No. MultiPlan provides network access. The underlying health plan determines whether PHP is a covered behavioral-health benefit and what authorization or medical-necessity requirements apply.
What is PHP?
Partial hospitalization is an intensive day-treatment level of care that does not require an overnight residential stay. Trinity offers a PHP / day treatment program.
Can prior authorization be required?
Yes. The insurer or plan administrator may require prior authorization, precertification, or utilization review even when a provider participates through a MultiPlan network.
What should I verify?
- The actual insurer or plan administrator
- Active eligibility
- The applicable MultiPlan network
- Trinity’s network status
- PHP benefits
- Prior authorization
- Deductible, copay, or coinsurance
For the network overview, see MultiPlan PPO networks for rehab at Trinity Behavioral Health.
Verify Your MultiPlan-Based PHP Benefits
Authoritative resources
- Claritev — Member Support and MultiPlan Network Information
- Claritev — Provider Network Information
- MultiPlan — Network Professional Handbook
- SAMHSA — Know What Your Insurance Covers
Exact benefits vary by the underlying health plan and should be verified directly.