We’re here 24/7 to listen and help.
We’re here 24/7 to listen and help.
Villa Healing Center works with UnitedHealthcare plans, and with Optum, the company that manages their mental health benefits. If you carry a UHC card and are considering residential treatment in the Los Angeles area, the name of your plan is the best early clue to what it will pay.
UnitedHealthcare prints the plan name on the front of the card. The name tells us how much freedom you have to choose a treatment provider.
Plans that generally let you choose providers outside UnitedHealthcare’s contracted list:
Plans that generally limit you to contracted providers, except in emergencies:
Members with a plan in the first group are the ones we can most often help. If your plan is in the second group, call us anyway. Employers sometimes add options that the plan name does not show.
UnitedHealthcare does not review mental health treatment itself. That work belongs to Optum, a sister company within UnitedHealth Group. You may also see it called United Behavioral Health on older paperwork.
Optum’s staff decide whether a residential stay is approved, for how many days, and whether more days are added. Our clinical team sends Optum the request and the records that support it.
For adults, Optum relies on a rating tool called LOCUS, short for Level of Care Utilization System. It was developed by a professional association of psychiatrists and scores a person in six areas:
The combined score points to a level of care. Residential treatment is recommended when the score shows that someone needs daily structure and staff on hand at all hours, without needing a locked hospital unit.
Knowing this helps you prepare. When you speak with our admissions team, be open about each of these areas. An accurate picture gives Optum what it needs to make the right decision.
California passed a law, known as SB 855, that took effect in 2021. For health plans regulated by the state, it requires coverage of medically necessary mental health treatment and requires insurers to use criteria written by clinical professional groups, such as LOCUS.
This law covers plans issued in California to individuals and to many employers. It does not reach plans that an employer funds itself, or plans issued in other states. We find out which category your plan falls into when we check your benefits.
You can see much of your plan yourself in a few minutes:
Bring what you find to the call. We will confirm it with Optum directly, because the portal does not always show approval rules or daily limits.
Some UnitedHealthcare products are government-funded, and we are unable to bill them. These include AARP Medicare Advantage plans, Dual Complete plans, and UnitedHealthcare Community Plan, which is the company’s Medicaid line. If one of these is your only coverage, our team can explain private payment.
Our program is for adults who need time away from daily pressures to stabilize and learn new skills. Therapy draws on established methods, including cognitive behavioral therapy and dialectical behavior therapy, and is tailored to conditions such as anxiety disorders and major depression. To see how the hours are spent, read a typical day in residential treatment.
Medical Director
Medical Director
Clinically reviewed by Dr. Courtney Scott, MD, Medical Director at Villa Healing Center. Board-eligible in Emergency Medicine, Internal Medicine, and Addiction Medicine per Villa’s published clinical leadership profile.
Read more about our team
Share your plan name and member ID by phone at (888) 669-0661 or through our insurance verification page. We contact Optum, confirm what your plan pays for a residential stay and explain the result to you.
