Quantum Health Solutions, Inc.
The OU Health Plan utilizes Quantum Health Solutions as its Managed Benefit Provider for these services. Utilizing a managed benefits program allows the Plan to provide quality treatment at a higher level of benefits than might otherwise be available to the patient.
The Orange-Ulster Health Plan is a Plan of choice. This means you have the choice of using either an in-network provider or and out-of-network provider. The choice of using In-Network providers would only require a co-pay as the In-network provider has agreed to accept certain payments for services.
The choice of using Out-of-Network providers would result in meeting an annual deductible ($1,000 for Individual and $3,000 for family), paying a co-pay and co-insurance. After meeting the annual deductible, the Plan would pay 80% of the Usual & Customary (U&C) charges (co-insurance) and you would be responsible for the balance of the charges.
When a member is in need of these services, it is important that they feel comfortable with their provider. When a provider, which a member “connects” with, is out-of-network, Quantum will contact that provider to discuss a favorable solution that would ensure the member would have effective and affordable care.
Quantum Nets’ mental health and substance abuse network consists of both local inpatient facilities and outpatient providers. All outpatient providers are licensed mental health professionals.
A member can contact Quantum, at 1-888-214-4001 for assistance in finding a provider that would be most beneficial to their needs.