MEMBER HANDBOOK - Community Care Behavioral Health

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48 Who can I call if my health is at immediate risk? Expedited Fair Hearing If your doctor or psychologist believes that using the usual time frames to decide your Fair Hearing will harm your health, you, or your doctor or psychologist can call the Pennsylvania Department of Public Welfare at 1-877-356-5355 and ask that your Fair Hearing be decided faster. This is called an Expedited Fair Hearing. You will need to have a letter from your doctor faxed to the Pennsylvania Department of Public Welfare at 1-717-772-7827 explaining why using the usual time frames to decide your Fair Hearing will harm your health. If your doctor does not send a written statement, your doctor may testify at the Fair Hearing to explain why using the usual time frames to decide your Fair Hearing will harm your health. The Bureau of Hearings and Appeals will contact you to schedule the Expedited Fair Hearing. The Expedited Fair Hearing will be held by telephone within 3 business days after you ask for the Fair Hearing. If your doctor or psychologist does not send a written statement and does not testify at the Fair Hearing, the Fair Hearing decision will not be expedited. Another hearing will be scheduled and decided within 90 days. If your doctor sends a written statement or testifies at the Expedited Fair Hearing, the decision will be made within 3 business days after you asked for the Expedited Fair Hearing. These are your Member Complaint and Grievances rights and responsibilities. Call us if you want us to explain them to you. Customer Services 1-800-553-7499
Section 6 Your Ombudsman Page What is an Ombudsman?.. . . . . . . . . . . . . . . . 51 How can I reach an Ombudsman?.. . . . . . . . . 51
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 14 and 15: 12 Services Specific To Children an
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 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

MEMBER HANDBOOK - Community Care Behavioral Health

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