Prism Quality Employee Assistance Program
Frequently Asked Questions

Provider Section : Questions

Q. Are you accepting applications to become a participating EAP provider?

Q. How will EAP referrals be made?

Q. How will sessions be authorized?

Q. Where can I find all necessary EAP paperwork?

Q. Can therapists refer for other treatment services within their own facility once EAP services are completed?

Q. What is the process for submitting claims?

Q. What assures us that we would be paid in a timely manner?

Q. What contacts do you have for easy access for problem resolution?

Provider Section : Answers

Q. Are you accepting applications to become a participating EAP provider?

A. In most counties, yes, we are accepting applications. Please contact our Network Development Department at 1-888-266-9041 if you are interested.

[Return To Top]

Q. How will EAP referrals be made?

A. Referrals may be made either of two ways. An EAP client may contact you directly to request EAP counseling. You will be able to differentiate EAP clients from other clients by the EAP referral number. You will then be required to contact the EAP to obtain a triage packet and inform us of the client’s first appointment date. In certain instances, an EAP clinician may also contact you to coordinate services for an EAP client.

[Return To Top]

Q. How will sessions be authorized?

A. At the time a referral is made, the EAP program will fax you a triage packet. Information regarding the number of sessions permitted under contract will be detailed in that packet.

[Return To Top]

Q. Where can I find all necessary EAP paperwork?

A. All credentialed providers are given a Prism Quality EAP Provider Manual at the time a contract is secured in your area. The Manual contains instructions and paperwork. Additional paperwork is available in the secure provider section of the EAP website at www.prismnetwork.com.

[Return To Top]

Q. Can therapists refer for other treatment services within their own facility once EAP services are completed?

A. If at any time during the EAP episode of care the patient presents with symtomatology consistent with a DSM IV diagnosis, our protocol is to stop EAP services and refer that patient to a mental health or substance abuse clinician for a complete assessment. The patient must be given a choice of providers, however, if they are comfortable being seen within the same facility, they may stay where they are.

[Return To Top]

Q. What is the process for submitting claims?

A. Claims may be submitted on a HCFA 1500 Form or the Prism Quality EAP Billing Form. Directions for claims submission can be found in the EAP Provider Manual and on the EAP website at www.prismnetwork.com.

[Return To Top]

Q. What assures us that we would be paid in a timely manner?

A. Once an episode of care has been completed, the case terminated and all billing documentation has been submitted, payment will be rendered within thirty (30) days of receipt. Claim forms must be submitted within ninety (90) days of the date of service. Consult your Provider Manual for further information regarding the billing process.

[Return To Top]

Q. What contacts do you have for easy access for problem resolution?

A. Problems are resolved in an expedient manner by contacting the EAP Program at 1-888-276-6632 or at eap@prismnetwork.com. The Prism Quality Program Manager is responsible for overseeing the complaint process and will respond to participating provider complaints and concerns within three (3) business days.

[Return To Top]