Providers

Welcome to the ValueOptions of California network of participating providers. This handbook is an extension of the provider agreement and includes requirements for doing business with ValueOptions of California, including policies and procedures for individual providers, affiliates, group practices, programs and facilities. It provides important information regarding the managed care features incorporated in the ValueOptions of California provider agreements and reflects the policies and procedures that are applicable to our Knox-Keene product lines.

ValueOptions of California is a wholly owned subsidiary of Beacon Health Option, Inc. (Beacon) and a health care service plan licensed under the Knox-Keene Act to provide Mental Health or Substance Use Disorder or Mental Disorder (MHSUD) and employee assistance program (EAP) services to commercial clients and health plans; ValueOptions of California also provides administrative services to Beacon’s administrative service only (ASO) clients.  As a Knox-Keene Plan, ValueOptions of California is strictly regulated by the California Department of Managed Health Care (DMHC). Where there is conflict between Beacon requirements and Knox-Keene regulations, this handbook will reflect the Knox-Keene regulations for ValueOptions of California business, if more stringent.

Together, the ValueOptions of California provider agreement, addenda, and the handbook outline the requirements and procedures applicable to providers in the ValueOptions of California networks.  Information specific to participating providers in the EAP network can be found in the EAP Provider Handbook.

ValueOptions of California also maintains a web site at www.valueoptionsofcalifornia.com.  Beacon maintains a separate handbook for requirements and information regarding the Beacon agreement.  Therefore, in addition to careful review of the information provided in this handbook, it is important to be familiar with the requirements provided at www.beaconhealthoptions.com.

ValueOptions of California may, by notice, amend or change any or all provisions of the handbook by providing 45 business days prior written notice to providers unless the amendment is material and not made in order to comply with a change in state or federal law or accreditation standards.  Refer to your ValueOptions of California participating agreement for information related to handbook or agreement amendments.  To the extent that there is an inconsistency between the handbook and the provider agreement, ValueOptions of California reserves the right to interpret such inconsistency. ValueOptions of California’s interpretation shall be final and binding.

Provider Handbook

EAP Provider Handbook

Handbook Glossary

Medical Necessity Criteria

Clinical Practice Guidelines

Additional Resource Documents

ValueOptions® of California Forms