Caregivers pressed officials on scarce behavioral‑health providers, reimbursement of 'super bills'

During the session’s Q&A an attendee described challenges finding behavioral‑health providers who accept young children or who have available openings, and asked whether Coordinated Care will accept and reimburse "super bills" submitted by caregivers who pay privately.

An unidentified participant said caregivers sometimes pay private out‑of‑network providers and receive a "super bill" they hope to submit for reimbursement. "My understanding is Coordinated Care doesn't accept the super bills to reimburse for that," the participant said, and asked how to break down that barrier.

Katie Ferguson of Coordinated Care replied that routine reimbursement of super bills is generally not supported, and urged caregivers and caseworkers to contact the plan’s care management team to find in‑network providers, request help locating resources in the area, or to have the contracting team consider recruiting providers in under‑resourced regions. "The biggest thing I would say is to contact our care management team...we'll do the research on our end to find somebody, within a reasonable distance," Ferguson said.

Takeaway: Coordinated Care acknowledged provider shortages in some areas and recommended using care management to identify network providers, explore exceptions in constrained circumstances and to flag geographic gaps to contracting staff. Presenters also reminded participants that when exceptions are needed, agencies may offer case‑by‑case support.