Optum-managed behavioral-health benefits may cover a partial hospitalization program (PHP) when the member’s underlying plan includes the service. Trinity Behavioral Health accepts Optum-managed benefits when the specific plan provides applicable coverage. Because Optum may administer behavioral-health benefits for another insurer or employer plan, PHP coverage, network status, authorization, and cost sharing must be verified from the exact policy.
Verify your Optum-managed PHP benefits before admission.
Can PHP require authorization?
Yes. Optum-managed behavioral-health plans can use prior authorization and level-of-care review. Requirements vary by the underlying plan and should be checked from the member’s current benefits.
What should I verify?
- Underlying payer or employer plan
- Active eligibility and PHP coverage
- Trinity’s network status
- Prior authorization
- Medical-necessity and continued-review rules
- Deductible, copay, and coinsurance
See Trinity’s PHP / day treatment program. For the broader relationship, see Optum Behavioral Health benefits for rehab.
Verify Your Optum-Managed PHP Benefits
Authoritative resources
- Optum — Substance Use Disorder Solutions
- Optum — Behavioral Health Level-of-Care Criteria
- SAMHSA — Know What Your Insurance Covers
Exact benefits vary by the underlying plan and should be verified directly. Optum administration does not guarantee PHP coverage or payment.