Frequently Asked Questions (FAQs)
Find answers to commonly asked member questions below.
Questions about Contacting LifeSynch
Question about Emergencies
What do I do if I have an emergency?Question About Lost Member ID Cards
What if I lose my card?Question About Medical Necessity
What is medical necessity?Question About Pre-certification (Authorization)
Question About Privacy
How does LifeSynch handle privacy issues?Claims
Where do I submit claims for services from non-network providers?
For Services from a Non-Network Provider:
Mail the forms provided to you by your mental health provider along with evidence of any payment made. Please ensure the following information is on the bill:
- Insured's and patient's ID numbers and the group number
- Total charge, diagnosis code and service code
- Date of service, provider's name, provider license and tax ID number
For All Other Claims
See our Claims section for mail, e-mail addresses and contact numbers.
What do I do if my claim is denied?
LifeSynch offers you the right to appeal any claims decision. Claims appeals should be made no later than sixty days from the date you receive your claims decision.
Request an Appeal Via E-mail, Phone or Mail
- Phone: 1-800-777-6330
- E-mail: G&Adept@lifesynch.com
- Mail: Be sure to attach any mitigating information to support your appeal of the original claims.
LifeSynch
2101 W. John Carpenter Freeway
Irving, TX 75063
Attn: Claims Appeal
What is an independent review organization (IRO)?
If you do not agree with the outcome of the LifeSynch appeal process, you may be eligible for a review by an independent review organization (IRO). Please refer to the attachments to your denial letter or contact customer service for instructions and information on the availability of an IRO.
Contacting LifeSynch
What hours can I call LifeSynch?
Our customer service helpline provides toll-free access 24 hours a day, 365 days a year. You can call this number on your member card to get help with finding network providers, checking your claims, and verifying benefits and eligibility. Also, see Contact Us.
Who am I going to talk with when I call LifeSynch?
You will initially speak with a customer service representative who will provide the answers you need or put you in touch with someone who can help you.
What kind of information will I need when I call LifeSynch?
You will need your insured's ID number, group number and employer's company name. This information should be listed on your insurance card.
Emergencies
What do I do if I have an emergency?
If you or a covered family member are in a life-threatening situation, call 911 or go to the nearest hospital. The hospital will contact us through the 800 number on your benefit card, and a licensed professional LifeSynch staff member will assist you.
In consultation with hospital staff, the LifeSynch care manager will authorize the appropriate level of care. Depending on your benefit plan, it may be necessary for you to be transferred to a facility that is participating in LifeSynch's network.
Pre-certification (Authorization)
What is pre-certification?
Pre-certification is the process of notification and approval of treatment (inpatient and outpatient) and services before they are delivered.The pre-certification process ensures communication with the treating provider and/or you prior to the procedure and verifies that your plan covers the procedure, the provider and the facility you are accessing.
Is pre-certification required?
It is best to call LifeSynch to determine if your plan requires pre-certification. When you call, our customer service representatives will refer you to a clinical care manager who will help you with the pre-certification process, if it is required.
Privacy
How does LifeSynch handle privacy issues?
LifeSynch follows national and state laws regarding confidentiality to protect your privacy. Also, see our Privacy Policies section.
LifeSynch Providers
Where does LifeSynch have providers?
LifeSynch has network providers and practitioners located across the country in all 50 states. A LifeSynch representative can assist you in selecting an appropriate practitioner or facility near you. You may also locate a LifeSynch practitioner or facility near you with our online provider directory.
Find a provider with the LifeSynch Provider Lookup Tool
Do I have to see a LifeSynch network provider?
Depending upon your particular benefit plan, benefits may be paid at a reduced rate or not at all, if you see an out-of- network provider. It is recommended that you call LifeSynch to verify your benefits prior to seeing a physician.
What if my provider isn't in the LifeSynch network?
You can do two things if you would like to nominate your provider to be part of the LifeSynch network:
- Ask your provider to call the LifeSynch Provider Relations Department to learn more about joining our provider network.
- Call the toll-free number on your insurance card and request your provider be contacted about joining the LifeSynch network.
What do I do if I have problems with my provider?
Please call the LifeSynch number on your card and give specific information to the customer service representative. The information will be forwarded to the appropriate department for an immediate review. In addition, a LifeSynch representative can assist you in deciding whether you need a referral to a different LifeSynch provider in your area.
Do I have to call LifeSynch to see a behavioral healthcare provider?
It is best to call LifeSynch to determine if your plan requires authorization prior to seeing a practitioner.
