This information can assist you if you are currently receiving mental health or chemical dependency services as of June 1 and are concerned about your care.
Tip: If your provider is not affiliated with MHN see "Continuity of Care Coverage" section below.
If you are receiving inpatient or facility-based treatment, your care manager or attending physician should call MHN at 1-800-977-7630 as soon as possible, prior to discharge or step down (change) in level of care. Arrangements will be made for your post-discharge or step down care, ensuring continuing care using your transition benefits, or referral to an MHN participating facility or provider.
Members who are receiving outpatient mental health services on 6/1/2010 will be eligible for outpatient sessions through 8/31/2010, according to state and federal regulations, subject to the limits of your benefit plan and subject to medical necessity review.
Note: You may find that your current provider is also an MHN participating provider and you may then get an authorization from MHN, effective 6/1/2010 to continue seeing them. If your current provider is NOT in the MHN network, you may be eligible for treatment as outlined under "Continuity of Care Coverage".
If your current provider is not affiliated with MHN, and if changing providers right away might have a negative effect on your health, MHN may temporarily cover services you receive from a non-MHN participating provider. This is known as "Continuity of Care Coverage".
Who is eligible:
How to begin:
If you or your provider feels that your condition might require continuity of care coverage, please call MHN at 1-800-977-7630 as soon as possible. A representative will ask you questions such as the name and telephone number of the provider you are currently seeing and what kind of care you are receiving. If you wish to initiate the process, you must consent to have an MHN representative contact your current, non-MHN provider for a confidential discussion of your behavioral healthcare needs.
The review process:
An MHN Care Manager will carefully review the information obtained from you and your provider and determine the best way to transfer your care from your current provider to an MHN participating provider. If continuity of care coverage is necessary, we will contact you and your current provider to arrange for your continued treatment.
Your current provider must agree in writing to the same terms and conditions that we require of our participating providers. If your provider will not agree, MHN will contact you regarding your treatment options.
Note: In the event you do not qualify for continuity of care coverage, MHN will do whatever we can to help you make the transition to your new MHN participating provider. This may include helping you select a provider or helping you with the referral process.
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