Home | Your Health Options | Behavioral Health

ParTNers Employee Assistance Program (EAP)/
Here4TN.com

Your Employee Assistance Program (EAP) is also administered by Optum. EAP services are offered at no cost to those individuals eligible to participate. Receive five EAP visits, per situation, per year at no cost to you.

EAP and Behavioral Health* Eligibility

State and Higher Education: EAP services are available to all benefits eligible employees and their eligible family members, even if they are not enrolled in medical insurance.

Local Education, Local Government, COBRA and Retirees: EAP services are available to those enrolled in medical insurance as well as benefits eligible (not necessarily enrolled) dependents of employees who are enrolled in medical insurance.

*Behavioral Health benefits are only available to those enrolled in medical insurance.

Master’s level specialists are available around the clock to assist with stress, legal, financial, mediation and work/life services. They can even help you find a network provider, a plumber who works nights, find services for your elderly parents, theater tickets, all-night pharmacies and so much more.

For a full list of mental health and substance use disorder services, click here.

  • Preauthorization is required to utilize your Employee Assistance Program. Simply go to Here4TN.com or call 855.437.3486 to obtain your preauthorization. If you prefer to access services over the phone, telephonic counseling is available as well as face-to-face appointments

State Only: With your manager's approval, you may use work time up to 10 hours annually, to see an EAP provider.

Optum also offers confidential and anonymous access to a wide variety of information and resources on their website at Here4TN.com or by calling 855.437.3486.In addition, your ParTNers EAP can deliver onsite trainings — more than 70 different trainings are available for groups of 15 or more. To access the training catalog and the online training request form, please go to the "Leaders" section on Here4TN.com.

Coming Soon! Take Charge at Work: Starting in the fall of 2017, you will have access to a telephonic program that helps you identify your triggers and recognize and manage symptoms of stress and depression. More details to come, including how to see if you qualify for the program.

Behavioral Health

Whether you are dealing with a mental health or substance use condition, support is available through your behavioral health coverage. Your enrolled dependents can use these benefits too.

Optum is your behavioral healthcare vendor. Using one of Optum’s network providers gets you the most from this benefit, which is included when you and your dependents enroll in a health plan.

In addition to office visits, this benefit includes virtual visits. What does that mean? You can meet with a provider through private, secure video conferencing. It’s called Telemental Health, and it allows you to get the care you need sooner and in the privacy of your home. EAP is now available through virtual visits as well.

  • The copay for Telemental Health is the same as an office visit. To get started, go to Here4TN.com, scroll down, select provider search, and click on Telemental Health to find a provider licensed in Tennessee, or call 855-Here4TN for assistance.

To receive maximum benefit coverage, participants must use a network provider. For assistance finding a network provider, call 855-Here4TN. Preauthorization is required for non-routine outpatient and all inpatient services.

You can learn more by visiting Here4TN.com or calling Optum toll-free at 855.HERE.4.TN (855.437.3486) any time, day or night, to speak confidentially with a trained professional for a referral or preauthorization. A provider directory with a search feature is available on the website.

Participants may see an out-of-network mental health provider without calling for a referral; however, coinsurance and copayments will be higher. Participants are also subject to balance billing by the out-of-network provider, meaning that they will pay the difference between the maximum allowable charge and the actual charge. In addition, participants are at risk of having inpatient benefits totally denied. Certain services are specifically excluded under the terms and conditions of the state group insurance program.

Behavioral Health Service Appeals

If you are in disagreement with a decision or the way a claim has been paid or processed, you or your authorized representative should first call member service at Optum: 855-HERE-4-TN to discuss the issue.

First Level Appeal — If the issue cannot be resolved through member service, the member or his/her authorized representative may file a formal request for internal review or member grievance by contacting Optum. All requests must be filed within the specified timeframes. When your request for review or member grievance is received, you will get an acknowledgement letter advising you what to expect regarding the processing of your grievance. Once a determination is made, you will be notified in writing and advised of any further appeal options including information about how to request an external review of their case from an independent review organization (IRO).

Second Level Appeal — If the member's first level appeal is denied, the member or his/her authorized representative may file a second formal request for internal review or member grievance by contacting Optum. All requests must be filed within the specified timeframes. When your request for review or member grievance is received, you will get an acknowledgement letter advising you what to expect regarding the processing of your grievance. Once a determination is made, you will be notified in writing and advised of any further appeal options including information about how to request an external review of their case from an independent review organization (IRO).

External Review — If the member's first and/or second level internal appeal is denied, the member or his/her authorized representative may choose to request that an IRO review the case and make a final determination. The IRO will communicate their decision to the member. This decision will be final and binding on the member, the plan and the Carrier.

The appeals/grievance form can be initiated by contacting Optum. Members will have 180 days to initiate an internal appeal following notice of an adverse determination. Notification of decisions will be made within the following time frames, and all decision notices shall advise of any further appeal options:

  • No later than 72 hours after receipt of the claim for urgent care
  • 30 days for denials of non-urgent care not yet received
  • 60 days for denials of services already received