ValueOptions

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Overview

ValueOptions, Inc. (VO) "is the largest privately-owned behavioral health maintenance organization (BHMO) in the United States." [W] This technically makes it an insurance company; the service they provide is more technically known as utilization management[W] (UM).

VO is a subsidiary of FHC Health Systems of Norfolk, VA.

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North Carolina

Among many other income streams (including both governments and private companies), ValueOptions is contracted by the state of North Carolina to provide utilization management[W] (UM) – i.e. to approve (or disapprove) funding requests – for mental health services funded by Medicaid or NC Health Choice in cases where the LME cannot (which is the overwhelming majority). They were added to the already confusing mix of agencies involved in NC's mental health care system as a cost-cutting measure, but it has had the usual effect of increasing costs and reducing services. It's not clear at what point ValueOptions became involved, but it was presumably sometime between 2003 and 2008.

On 2010-09-20, UM for the Durham County LME has been reclaimed by The Durham Center. There are apparently only a handful of LMEs in NC which are able to provide their own UM service, and reclaiming the service after allowing it to be farmed out to ValueOptions is apparently a first.

Contact

VO appears to be an extremely opaque organization, from the standpoint of a service recipient:

  • There are no email addresses listed for inquiries about service denials, approvals, or appeals.
  • The phone number connects you to a menu system with multiple levels, and where it is not clear which options you should be choosing in order to speak to someone.
  • Their web site has no "contact us" or "make a suggestion" forms, although if you create a "Member" account and log in, you will have access to what appears to be a messaging system -- but when I tried it, it was "not available" for my account; see htwiki:User:Woozle/blog/2009-10-20 2131 what I learned about ValueOptions today.

The only email addresses we have been able to locate are:

  • purchasingspam@spamvalueoptionsspam.spamcom - listed on the whois for valueoptions.com (which also lists them as "a dividion of FHC Health Systems" in "Norfolk, VI"
  • EmployerSalesspam@spamValueOptionsspam.spamcom - listed on their Client Online Services page (no, this is not for clients like you; this is for real clients – you know, people with money who want to pay VO to provide services)

Their "Health Utilization Management" accreditation listing at the URAC web site gives these addresses:

Encounters

When I called VO this afternoon, I had to go through about 5 levels of menu to get to a person. That person wanted my name and the client's ID (we had to go back and forth a bit before figuring out that his NC Health Choice ID was sufficient) and birthdate before they would give me the time of day. A brief conversation revealed that an appeal had already been filed, but the representative did not have any other information about it, and offered to forward me to someone in the Appeals department. I agreed -- and was treated to a message that the number I had dialed (919-733-2698) had been changed to another number (919-431-3000). Why it didn't just connect me to that number, since this was an internal transfer, I don't know. --Woozle 19:15, 22 June 2009 (EDT)

See HypertWiki for more encounters.

Links

Official

Reference