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URMC / BHP / Frequently Asked Questions

 

Frequently Asked Questions

Who is eligible for services at BHP?

To be eligible, you must be a regular full-time or part-time member of our faculty or staff, or a non-Medicare eligible retiree, enrolled in a University Health Care Plan. Enrolled spouses and domestic partners, as well as dependent children age 18 and older, are also eligible. BHP does not provide pediatric services, and therefore enrolled children under age 18 are not eligible for BHP Plan benefits.
2017 Eligibility Table

What is the cost of services?

YOUR PPO Plan: There is no out-of-pocket cost for services at BHP (Services received through BHP are not subject to the $20 co-pay per visit).

YOUR HSA-Eligible Plan: Services received through BHP are subject to the annual deductible and are covered at 100% after the annual deductible is met.
If you have an HSA plan and would like more information on the cost of services, please call the Health Care Cost Estimator at (585) 758-7801 Monday through Friday between 8:00 a.m. and 5:00 p.m. The estimator will ask you for a billing code. Please select the appropriate code from the list below.
  • 90791Z – New Patient Visit
  • 90834Z – Follow Up Visit
  • 99203 – Medication New Patient Visit
  • 99213 – Medication Follow Up Visit

How do I use my University Health Care Plan for BHP services?

BHP will need to confirm your coverage through your Third-Party Administrator (TPA), which is either Aetna or Excellus, when scheduling an appointment. As there is no out-of-pocket cost to you or your covered dependents (age 18 and older) if you are enrolled in the PPO Plan, no claims will be processed through your Health Care Plan. However, federal regulations governing HSA-eligible plans require that HSA-eligible Plan members pay the allowable cost of all covered medical and pharmacy benefits until after they have satisfied their deductible. Therefore, if you are an HSA-Eligible Plan member, BHP will submit your claim to your TPA and will bill you for services until your deductible is satisfied.

If my spouse or domestic partner has insurance through his/her employer, can he/she still be seen in BHP?

No, unfortunately not. BHP is a benefit available only to those who are enrolled in the University of Rochester Health Care Plans.

Do I need a referral to be seen in BHP?

No. Referrals or prior authorizations are not necessary.

I already have a mental health counselor in the community. Can I continue to see my counselor, and come to BHP just to see a psychiatrist or nurse practitioner who will prescribe my medications?

It is possible, depending on your treatment needs. To determine whether a BHP provider should have a role in your medication treatment, you can meet with a BHP provider who will review your current treatments and need for medication management. If you would like to set up an appointment with a BHP provider, call the BHP office for an appointment

My PCP is prescribing my psychiatric medications, and he/she would like to get a consultation about possible changes to make my medications more effective. Is that possible?

Yes, please ask your PCP to call BHP to request a medication consultation.

Are my records stored in eRecord?

Our records are part of the University of Rochester electronic medical record system known as eRecord. Electronic medical records (EMR) improve the consistency and coordination of individual health care, allowing us to provide higher quality care with greater attention to patient safety. With eRecord, you and your care team have access to important information about your medications, allergies, medical conditions, and treatments that may affect your emotional well-being or response to medications. We appreciate that your health information is private and must be carefully protected. Following confidentiality laws (HIPAA) on patient privacy, all EMR access is logged and retained and only those who are involved in your treatment or in Plan administration are permitted to see it.

Do you treat alcohol or drug dependence at BHP?

No, we do not have those services.  Your primary care physician or the Employee Assistance Program should be able to make a referral.

Can I be evaluated or treated for ADD/ADHD in BHP?

We do not evaluate or treat primary diagnoses of attention deficit disorders in BHP  Please discuss your treatment options with your primary care physician or you may contact the Employee Assistance Program for a referral.

Will I be informed if my family member seeks treatment in BHP?

No, BHP will not inform you if a covered dependent seeks mental health care in BHP.  HIPAA protects the privacy and confidentiality of health care.  BHP cannot ensure, however, that your family members' participation in mental health care will be fully concealed.  Family members could learn about participation in mental health care through correspondence sent to the home, billing statements, or if family members have overlapping appointments in BHP.