MEMBER HANDBOOK - Community Care Behavioral Health

More documents

Recommendations

Info

12 Services Specific To Children and Adolescents • Behavioral Health Rehabilitation Services (BHRS) for Children and Adolescents • Residential Treatment Facilities (RTF) • Family-based Treatment Other Services If you do not know what kind of services you need, call Community Care. Special Needs If you are in a wheelchair, speak little English, don’t hear well, or have other special needs, you have the right to extra help. Please call us. Transportation If you cannot afford bus fare, live far away from public transportation, or cannot travel without aid, you can get help with transportation. You can use the Medical Assistance Transportation Program (MATP) to get to your behavioral health appointments. You can call MATP directly at 412-350-4476 or at (toll-free) 1-888-547-6287. You can also call Community Care to find out how to apply for MATP. Ambulance services that you use in an emergency are paid for by your physical health plan when they are necessary based on your condition. MATP does not provide emergency transportation services. Customer Services 1-800-553-7499
13 Payment for Treatment We pay your bills for treatment. There are no co-payments or deductibles for the behavioral health care that we approve. We will only pay for care from an out-of-network provider if we approved it ahead of time or if it was an emergency. Out-of-Network: When a provider or a hospital doesn’t have a contract with Community Care to give care to our members. You should not receive a bill or be asked to pay for behavioral health services when you receive treatment from an in-network provider. If you get a bill for services from a Community Care provider, please call us or send the bill to: Community Care Behavioral Health Organization One Chatham Center, Suite 700 112 Washington Place Pittsburgh, PA 15219 Attention: Complaints and Grievances Department If You Have Other Insurance If you have Medicare or another insurance plan, please tell us. We work with your other insurance plan to make sure your services are paid for. Customer Services 1-800-553-7499
Page 1 and 2: Behavioral Health Services MEMBER H
Page 3: Si Ud. necesita la versión en Espa
Page 6 and 7: 4 HealthChoices People in Pennsylva
Page 8 and 9: 6 Community Care Offers Information
Page 10 and 11: 8 Your Physical Health Community Ca
Page 12 and 13: 10 Customer Services 1-800-553-7499
Page 20 and 21: 18 Your child or teen might get hel
Page 22 and 23: 20 If the situation is life-threate
Page 24 and 25: 22 Privacy We will not let anyone e
Page 26 and 27: 24 C. Any reasons why you could not
Page 28 and 29: 26 You Also Have the Right... (cont
Page 30 and 31: 28 You Can Ask About Mental Health
Page 34 and 35: 32 When should I file a First Level
Page 36 and 37: 34 What if I do not like Community
Page 38 and 39: 36 You must send your request for a
Page 40 and 41: 38 When should I file a First Level
Page 42 and 43: 40 The Second Level Grievance revie
Page 44 and 45: 42 What can I do if my health is at
Page 46 and 47: 44 Persons Whose Primary Language i
Page 48 and 49: 46 How do I ask for a Fair Hearing?
Page 50 and 51: 48 Who can I call if my health is a
Page 64 and 65:
62 DPW Fraud and Abuse Hotline The
Page 66 and 67:
64 Call Community Care Customer Ser
Page 68 and 69:
66 Definitions Advocate A person wh
Page 70 and 71:
CC HCAL MHB 01-2013 (MA) 68
Page 72:
Community Care Behavioral Health Or
show all

MEMBER HANDBOOK - Community Care Behavioral Health

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?