To submit an electronic form, you can click on the following link to access the online submission form: Carebridge Billing Form

To submit a paper form, you can click on the following link to access the PDF submission form: EAP Billing Forms - 2024.pdf EAP Billing Form (PDF)

Carebridge mails paper checks (3) weeks after the billing forms have been processed.

Currently, Carebridge does not offer EFT. We mail paper checks to the mailing address listed on the current W9 we have on file.

Billing forms are required within 45 days from the most recent session date.

If you have a billing form with session dates past the 45-day timely filing, please call Carebridge Billing Department to verify if the late billing form can be approved for payment.

No, we do not accept HCFA forms in place of our billing forms. Carebridge is not an insurance company, and we do not use diagnosis codes.

Members will need to call Carebridge to speak with a counselor to determine eligibility for any additional sessions. Carebridge cannot approve members for additional sessions at the request of the  provider.

Network providers may enforce their practice’s missed appointment/late cancellation policies after the member has reviewed and signed acknowledgement of said policy. Providers should not charge Carebridge for any missed sessions or late cancellations.

Yes. You must have a valid Carebridge EAP authorization prior to seeing a member and they are not permitted to use their EAP sessions without prior eligibility verification and approval from Carebridge.

No. EAP members are not allowed to be seen by an intern, graduate student, psychological assistant, or pre-licensed/non-licensed professional. The member is only authorized to see the Network Provider to whom the authorization is addressed.

Please fill out the Network Provider Inactivation Form. You may also contact us by email at providernetwork@carebridge.com and let us know the status of your practice and the length of time you would like us to hold referrals.

Yes. You can self-refer as long as you make the member aware of any and all financial obligations that may occur with sessions beyond the EAP benefit.

Members are limited to the number of sessions provided by their employer through the EAP. If a member needs or wants to continue counseling, they may use their health insurance benefits or pay out of pocket. Please make the member aware of all financial obligations should they choose to continue counseling beyond the EAP.

Please notify Carebridge immediately and ask the member to contact Carebridge as well. Network Providers are not permitted to fill out paperwork for members and are not permitted to contact the manager, supervisor, or HR department of the member’s employer.

Please contact the Provider Relations team at Carebridge by email at providernetwork@carebridge.com. Or you can submit the electronic Network Provider Change Form.

Network Providers are encouraged to submit billing through the secure portal using the Carebridge Billing Form.
If you prefer to complete a paper billing form, download a PDF version of the eletronic billing form and send it to us by secure email or FAX. The Fax number can be found on the form: EAP Billing Form (PDF)