Formal Referrals

Authorization – The following guidelines apply to all referrals made by MYgroup.

1. The number of authorized sessions is found on the Authorization of Service form. Authorization for additional sessions must be discussed with MYgroup.

2. You must call MYgroup at 866-850-2175 to discuss appropriate clinical recommendations. Do not contact the client’s employer under any circumstances.

3. Referring to yourself or any professional in your practice is not permitted unless authorized by MYgroup. If on or before the second visit you assess that the client will need longer-term care than the EAP can offer, the client should be referred out of the EAP, taking into consideration the client’s insurance benefits.

Authorization for Release of Client Records

* Please note that MYgroup does not reimburse for late cancellations or “no shows.”

Mail all information to MYgroup, 5925 Carnegie Blvd., Suite 350, Charlotte, NC 28209. Or, fax all information to 704-529-5917. Attn: Provider Relations Department.