What the heck is a mental health carve-out?

Mental health carve-out:
When mental health benefits are covered under a different payer/play than the medical benefits or ‘carved out.’

Example: A client can come in and say they have BCBS insurance but when you verify benefits, they might have United Behavioral Health as their mental health coverage.

In this case, you would bill United Behavioral Health, and if you are out-of-network with that plan, you are considered out of network, even if you are in-network with BCBS.

More information about these tricky tricksters and other insurance verification tips are available in my Ins and Outs of Insurance Verification E-book™.

Here is a quick video I did explaining mental health carve-outs.