An Employee Assistance Program, or EAP, is an employer-sponsored benefit that provides a set number of therapy or behavioral health sessions. Benefits may also come through an insurance authorization or another sponsoring organization, city, school, or employer-related program.

Many EAPs extend coverage to an employee’s household members, including people who are not enrolled as dependents on the employee’s medical plan. The number of sessions, eligibility rules, expiration dates, and signup requirements vary depending on the program.

Depending on the benefit, a client may have:

• A set number of covered sessions or credits.
• An authorization code or authorization record.
• An effective date and expiration date.
• Sponsor-specific session-duration or documentation requirements.
• A fixed payout structure that does not increase when a session runs longer.

Session duration requirements

Some benefit sponsors have 45-minute session duration requirements with a fixed-rate structure. This benefit provides short-term support for mental health and other personal challenges without sacrificing strong, effective care. For many clients, that structure gives enough time to build connection, address the presenting need, and move care forward in a way that fits the allowed benefit. Following the session duration requirements helps preserve access, aligns with sponsor expectations, and keeps the referral type within its intended scope.

For sessions with duration requirements, providers will see banners and alerts on the impacted sessions. Providers should follow the specific guidance provided. If sessions are shorter than 45 minutes, there may be risk of the benefit being denied. If sessions run longer than 45 minutes, payout remains at a fixed rate.

Once those benefit sessions are used up, and the client transitions to another coverage method, providers may hold shorter or longer sessions as desired. Session rates will follow the standard rate buckets according to client referral type.

Identifying sessions with duration requirements

Navigate to a client's profile. Under the "Coverage" session, you will see "EAP" with the number of sessions the client is allotted. Click on the card for more details.

Navigate to your calendar. Sessions with a duration requirement will have a "shield" icon. Click the session for more details.

If you are scheduling a session that is covered by a benefit with duration requirements, you will be notified before scheduling. We recommend adjusting the session duration to be 45-minutes.

When joining a session, you will be notified of duration requirements.

What if a benefit requires an authorization?

Some benefits require an authorization before the client can schedule or use covered sessions. When an authorization is required, the client or care team must provide the authorization details before scheduling in Tava Health.

If your client has questions about benefit sessions, direct them to this article or their benefit provider.

Supporting your long-term practice

Many clients who start by using an EAP benefit for a specific challenge they’re facing are highly motivated and lower acuity. Most clients discover the benefits of therapy through this doorway, and decide to continue with longer-term therapy. For this reason, Tava Health’s care continuity pathways are specifically designed to make it easy and intuitive for clients to continue care with the same provider.

Tava Health supports providers as they build a full caseload by connecting the broadest source possible for client referrals. These sessions bring substantial client volume, reduce administrative friction, and fit into a broader consolidated practice through Tava Health’s free EHR, zero-claw-back billing, built-in telehealth, and automatic scheduling and documentation tools.

Our partnerships bring meaningful referral volume through an EAP model, so providers can fill their schedule gaps and deliver meaningful care.

FAQs

• Can I opt-out of benefit sessions?
  • Providers can turn off Tava Referrals anytime, here. In-network providers cannot selectively opt-out of accepting a client's valid EAP benefits if they are actively credentialed with the insurance network tied to the agreement. However, providers can choose not to work with a client on a case by case basis if the fit is not right.
• Why do some sessions have duration requirements?
  • EAPs are meant to provide short-term mental health support at no cost to the individual. 45-minute sessions help ensure the program is feasible for employers to provide, and protects provider time. Session durations are determined by the program, and cannot be modified by Tava Health. 
• How do I know if a session has duration or payout rules?
  • For sessions with duration requirements, providers will see banners and alerts on the impacted sessions. 
• How do I adjust the session length?
  • For guidance on how to adjust session length, see this article.
• What is the client experience?
  • You can learn more here.
• Do benefits cover couple or family therapy sessions?
  • Yes. Couple and/or family therapy sessions can be covered by EAP benefits. 
• The benefit details say "pending." What does that mean?
  • If you see "pending verification," the benefit has not yet been confirmed by the payer. You may still hold the session. If the benefit is not confirmed, the client's insurance will be used to cover the session instead.