May 2026 Top of Mind

Help protect SCO and One Care (D-SNP) members: No balance billing for covered behavioral health services

Providers may not balance bill for covered behavioral health services. This is designed to help members avoid additional out‑of‑pocket costs beyond what is allowed under their benefit plan.

What this means

• Members must not be charged the difference between visit charges and the amount reimbursed by Optum
• Payment received from Optum represents payment in full for covered services when submitted according to rendered in accordance with plan requirements

We recommend reviewing your billing practices to confirm alignment with plan policies. General guidelines are outlined in the National Provider Network Manual, which you can find on the public  Provider Express website.

Have questions or need assistance?

Please call the number on the back of the member’s ID card or the Optum Massachusetts Dedicated Provider Services line at 1-866-860-7308, 8 a.m. – 8 p.m. ET, Monday – Friday.