When we both succeed, we both win – participating with Mazzitti & Sullivan EAP will help you to build up or sustain your practice while helping us to offer a wider variety of agencies to our clients.
Paperwork
(All links are PDF format. If you do not have the free Adobe Acrobat Reader installed on your computer, please click here and download it.)
If you are a new provider, please download the New Clinician Packet. This packet contains all of the forms you will need to complete and send back to us. Please call us with any questions!
If you are already a participating provider with us but just want to add a new location, change your address, name, and/or phone number, please fill out a new Agency Information sheet and a new W-9.
If you are already a participating provider but wish to add a new counselor to the EAP roster, please complete the Counselor Information pages.
Forms
Here are the forms you need to complete when you see a client through Mazzitti & Sullivan EAP Services:
- EAP Initial Evaluation Report Form (Complete at/after the first session.)
- Employee Consent Form (Have client sign at first session.)
- EAP Summary Report Form (After the last authorized EAP session, or after two months with no sessions – whichever comes first.)
- EAP Invoice (HCFA forms also accepted.)
And that’s it! We strive to keep our paperwork to a minimum and do all that we can to make the process easy for our clients as well as for our providers.
FAQs
To reach an Account Manager please or call us at 1-800-241-5740.
These are our most commonly asked questions. Check them out before you call to see if your question has already been answered.
- Is there a lot of paperwork involved when a client is referred?
- How do I submit the paperwork?
- When can I expect to be paid?
- How many sessions does a client receive?
- Can the client use other family member sessions if that family member isn’t going to use them?
- What if I don’t hear from a client for a long time after their first session?
- What is / where can I find / how do I get an authorization number for someone?
- Can I retroactively bill for someone? How far back can I bill?
- Your reimbursement rate is too low. Can I balance bill?
- May I self-refer?
- What do you pay for no-shows / late cancels?
- The client lost his/her job. Do they still get EAP sessions?
Is there a lot of paperwork involved when a client is referred?
When a client is referred, there are four pieces of paperwork that need to be filled out when counseling has been completed: an initial evaluation, a release of information, a discharge summary, and an invoice. If you have a system that automatically generates a HCFA-1500 invoice, we will accept that in lieu of our invoice.
How do I submit the paperwork?
The paperwork can either be mailed or faxed to our office.
Provider invoices are paid around the 15th of the month following the month it is received. So an invoice received in January is paid around the 15th of February.
How many sessions does a client receive?
That depends on the company the client works for. The approved number of sessions will be written in the upper-right corner of the referral.
Can the client use other family member sessions if that family member isn’t going to use them?
Individually, each family member is only allowed to use those sessions approved for each person. In a three- session model, each family member is allowed three sessions on their own. However, if they are attending family counseling, these sessions can be combined. A family of three would be able to attend nine sessions together.
What if I don’t hear from a client for a long time after their first session?
If a client has had no contact with the therapist for two months, then the client is to be discharged and needs to go through an EAP account manager to be eligible for more sessions.
What is / where can I find / how do I get an authorization number for someone?
We do not use authorization numbers for our clients. The referral form serves as your authorization for sessions (the approved number is in the upper right corner of the form), and if you have any questions you may call us.
Can I retroactively bill for someone? How far back can I bill?
You may bill for a session that was completed prior to authorization as long as you have not billed the client or his/her insurance for that session. Please call us if the difference is more than a week, so that we may make a note when the bill comes in.
We do not impose any penalties for “late filing.” As long as you saw a client, you may bill back as far as you need to – however, if it has been longer than a year since the date of service, please call us before submitting.
Your reimbursement rate is too low for me. Can I balance bill?
Absolutely not. The EAP session is intended to be completely free to the client, and balance-billing undermines this central tenet of the program.
Participation with the EAP is voluntary, and you are free to request removal from our provider network at any time.
Yes! In our many years of experience, we recognize that the therapeutic relationship is most effective when there is a rapport between the counselor and client, and if things are going well with the client we see no reason for him/her to transfer to a different therapist after the EAP sessions.
You do not have to self-refer if you feel a different clinician or level of care would be most appropriate for the client.
What do you pay for no-shows / late cancels?
Unfortunately, we do not pay anything for no-shows/late cancels; however, you are permitted to consider that session forfeited by the client. For example, if we authorize 3 sessions for a person but she no-shows for the first session, you cannot bill us (or the client) for that session but may advise the client that she only gets two free sessions with you since she no-showed for the first.
Many providers have a policy that they will not reschedule a client if he or she has two no-shows/late cancels. Please let the client know of your specific policy and refer them back to us if you do not wish to reschedule the client
The client lost his/her job. Do they still get EAP sessions?
Yes. If we have approved sessions for a client, he or she is still eligible to use all of the approved sessions, even if they have started a new job in the meantime.