Ohio Department of Health
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Explanation of Mental Health Benefits

The following information is provided to assist in filing provider claims for Outpatient services:

Coverage:  Provided by United Behavioral Health (UBH) for employees with state health insurance also known as OptumHealth Behavioral Solutions.

Limitations: Unlimited, open certification for one year

Authorization: No preauthorization required

Co-Pay:  $20 per visit in network; out of network $30 (balance billing applies).  Emergency room $75, intensive out-patient care in network $20 and intensive out-patient care out of network $30.

Claim: Mental Health Coverage. NO paid EAP benefit. Submit completed claims to United Behavioral Health (UBH).

Claims Address for Billing:
United Behavioral Health
P.O. Box 30755
Salt Lake City, Utah 84130-0755 

Questions: Further information regarding coverage or benefits can be address through your UBH provider portal or by contacting 1-800-852-1091. Provider Services press #4 and Member Services press #3.

 Last Updated: 8/29/2012