Check Your Insurance Coverage

We encourage you to be PROACTIVE, be an INFORMED CONSUMER!  KNOW YOUR HEALTHCARE PLAN!  Most healthcare insurance plans have benefit coverage for the Early Childhood Partial Hospitalization Program (ECPHP).  I encourage you to call your plan to find out how our program is covered and what your out-of-pocket expenses will be. 

Please note that the Resnick Neuropsychiatric Hospital at UCLA is not contracted with Medi-Cal for partial hospitalization services.  Therefore, they will not reimburse for our program.

If you’d like to find out how your insurance plan covers our program, here’s a quick guideline for you to check your benefits.

Call your customer service/member service phone number on your healthcare card.

Always write the date you call and the name (first name and last name initial) of the customer service representative you speak with.

Let them know that your child is going to be admitted to the Early Childhood Partial Hospitalization Program (ECPHP) at the Resnick Neuropsychiatric Hospital at UCLA.  You’d like to find out how this service is covered under your insurance plan and what your copay will be.

Questions to ask:

• Is this a self-funded plan?  Self funded plans are not regulated by the California Insurance laws.
• Are there any exclusions for the treatment of autism 299.00 (F84.0)
• This service will fall under your Mental Health - Behavioral Health benefits, not the Major Medical benefits.
• Is the Resnick Neuropsychiatric Hospital at UCLA a participating provider, a contracted provider?
  Resnick Neuropsychiatric Hospital at UCLA
  150 UCLA Medical Plaza
  Los Angeles, CA 90095
  310-825-0511
• How is partial hospitalization covered?   Insurance plans often cover partial hospitalization either under the inpatient or outpatient benefit.  Some plans will have a separate benefit for partial hospitalization.   Make sure they understand that this is not a 24-hour inpatient, overnight hospitalization.  Nor is this an outpatient, 1-hour office visit.   ECPHP operates Monday – Friday, from 8am to 2:00pm, 6 hours per day.
• What is my deductible and co-pay?
• Are there any benefit limitation (either dollar amount or days) per calendar year?
• Does ECPHP need to be precertified before my child is admitted?  Once we have an admission date for your child, our Admissions Department will also call your healthcare plan to verify the benefits you have available. But all healthcare plans state a disclaimer when providing benefit information:  Verification of benefits does not guarantee the accuracy of the information. Verification of benefits does not guarantee payment.

Therefore, as the plan member, it is important that you too, call your healthcare plan to obtain benefit information.  Ultimately, you, as the plan member, are responsible for knowing how your plan works.