Quick Action and Big Savings for Mental Health Care

Phia received a request from a newly minted Unwrapped client requesting a mental health therapy SCA for a member who had been admitted as an urgent case and was continuing treatment. The claims forms provided to Phia for review were $127k, and the client wanted an agreement in place for completed and continuing treatment.

 

In this case, there were no previous SCA discussions between the client and facility that Phia was aware of, nor any contact information. After conducting some research on the facility, Phia was able to pinpoint a few people at the organization who would be the appropriate contacts for SCA discussions.

 

Mental health claims can be difficult to dissect due to the nature and sensitivity of the treatment. Phia and this facility worked quickly for the sake of the patient to ensure an agreement would be in place promptly. In a matter of 10 business days, Phia and the facility had an agreement in place that the Unwrapped client approved for less than 50% of the original billed charges.

 

By partnering with The Phia Group, the Unwrapped client saved $72,000.00 on completed treatment, had an SCA in place for the continuing treatment, and the patient never had to pause their services.