MultiPlan or PHCS for Therapy

MultiPlan Is Now Claritev

If you see the MultiPlan or PHCS logo on your health insurance card, you may assume these are health insurance companies. Private Healthcare Systems (PHCS) is a Preferred Provider Organization (PPO). That means health insurance companies work with PHCS and its parent company, Claritev (formerly MultiPlan), to give you access to its extensive PPO network of providers who agree to offer their services for an agreed-upon discounted rate.

Many therapists are part of Claritev’s MultiPlan or PHCS Network to make therapy more affordable for clients.

Does PHCS or MultiPlan Cover Therapy?

PHCS and MultiPlan are not insurance plans. Instead, they offer access to a large network of health care providers that work with your PPO health insurance plan, including therapists, mental health counselors, and psychiatrists.

PHCS works with a wide range of plan types, so the amount of coverage will vary. Health insurance plans can customize the PHCS Network in any way they choose, allowing them to include or exclude specific specialties.

Many health insurance companies that partner with PHCS offer members coverage of therapy costs. Seeing a therapist in-network with PHCS is the most affordable option, as seeing an out-of-network therapist may cost more out-of-pocket.

How Do I Check if My PHCS PPO Covers Therapy?

Because PHCS is not a health insurance plan, the company cannot provide you with specific information about your coverage. To check if your insurance covers therapy, contact your insurance company, health plan administrator, or human resources representative directly. Your health insurance card may also list a phone number for this purpose.

Another option is to locate your summary of benefits and coverage. This document outlines whether your PPO plan offers coverage for mental health services, like therapy. It also lists out how much cost is your responsibility based on the service type. Look for the “outpatient mental health services” or “behavioral/mental health outpatient” line. Here, you’ll find a copayment or coinsurance rate.

You should receive a summary of benefits and coverage document when you sign up with your health insurance provider. You can also find it online through your insurance portal.

Example PHCS Summary of Benefits, with outpatient mental health section highlighted

How Do I Check if My Therapist Is In-Network With PHCS?

The Claritev online provider search contains all the mental health professionals participating in the PHCS and MultiPlan networks, including therapists. You can search for your counselor or therapist directly on the website to see if they are in-network with PHCS.

Therapy Cost With My PHCS Plan

PHCS does not administer plan benefits or pay claims to the doctors or clinics within their network. That means coverage depends on your specific health insurance plan. Different plans have varying levels of coverage, with some covering all therapy sessions and others only paying for a limited number of sessions or specific types of therapy.

Under the Claritev umbrella, PHCS helps build and manage custom provider networks that allow for more cost-effective care. This results in higher than average savings by claim type, including:

42% for practitioners
28% for inpatient care
24% for outpatient care
46% for ancillary medical services.

Once you find out if your therapist is in-network, you can determine the exact rates before you start therapy sessions.

Types of Therapy PHCS Covers

Insurance coverage for therapy depends on your health insurance plan. The PHCS Network includes many licensed therapists, including those who provide evidence-based therapy modalities like:

Whether or not your therapist is in-network, most health insurance plans require you to receive a diagnosis from a therapist. Some of the most common mental health conditions covered by PPO plans include:

Find Vetted Therapists In-Network With MultiPlan or PHCS

Because PHCS and MultiPlan are PPO provider networks, you do not need a referral from your primary care physician before searching for a great therapist. This will save you time, and it also opens the doors for the beginning of your mental health journey with a therapist who is a perfect match for you.

Zencare connects you with multiple providers, so you can find a therapist that meets your exact mental health needs. Take our matching quiz or click on your state to find a vetted therapist who is in-network with PHCS or MultiPlan: