Mental Health and Substance Abuse Services rendered in connection with a Condition not classified in the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) are excluded from coverage; and services for the following categories (or equivalent terms) as listed in the most recent edition of the DSM: inpatient treatment for dementia and amnesia without a behavioral disturbance that necessitates mental health treatment; sexual deviations and disorders except for gender identity disorders; tobacco use disorders, except as required under USPSTF preventive care guidelines; pathological gambling, kleptomania, pyromania; inpatient stays primarily intended as a change of environment; school and/or education services, including special education, remedial education, wilderness/outdoor treatment, therapy or adventure programs (whether or not the program is part of a Residential Treatment facility or otherwise licensed institution); services provided in conjunction with school, vocation, work or recreational activities.
Mental Health and Substance Abuse Services. Benefits are provided for professional (Physician) office visits for the diagnosis and treatment of Mental Health and Substance Abuse Conditions in the individual, family or group setting.
Mental Health and Substance Abuse Services. Members, a designated representative, or a provider on behalf of the Member may contact the MHSA by telephone, letter, or online to request a review of an initial determination concerning a claim or service. Members may contact the MHSA at the telephone number provided below. If the telephone inquiry to the MHSA’s Customer Service Department does not resolve the question or issue to the Member’s satisfaction, the Member may submit a grievance at that time, which the Customer Service Representative will initiate on the Member’s behalf. The Member, a designated representative, or a provider on behalf of the Member may also initiate a grievance by submitting a letter or a completed “Grievance Form”. The Member may request this Form from the MHSA’s Customer Service Department. If the Member wishes, the MHSA’s Customer Service staff will assist in completing the Grievance Form. Completed Grievance Forms should be mailed to the MHSA at the address provided below. The Member may also submit the grievance to the MHSA online by visiting xxxx://xxx.xxxxxxxxxxxx.xxx. 0-000-000-0000 Blue Shield of California Mental Health Service Administrator
Mental Health and Substance Abuse Services rendered in connection with a Condition not classified in the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, are excluded from coverage.
Mental Health and Substance Abuse Services. Inpatient Mental Health & Consult the current Benefits Substance Abuse Book Outpatient Mental Health Consult the current Benefits & Substance Abuse Services Book
Mental Health and Substance Abuse Services professional office visits for the diagnosis and treatment of Mental Health and Substance Abuse Conditions including the individual, family, or group setting.
Mental Health and Substance Abuse Services. HOSPITAL ADMISSIONS MUST BE AUTHORIZED OR APPROVED BY THE MENTAL HEALTH AND SUBSTANCE ABUSE MANAGEMENT PROGRAM. PRIOR AUTHORIZATION WILL BE OBTAINED BY CONTRACTING PROVIDERS.
Mental Health and Substance Abuse Services. HOSPITAL ADMISSIONS MUST BE AUTHORIZED OR APPROVED BY THE MENTAL HEALTH AND SUBSTANCE ABUSE MANAGEMENT PROGRAM 9.1 Definitions Mental Illness and Emotional Disorders are broadly defined as including any mental disorder, mental illness, psychiatric illness, mental condition, or psychiatric condition (whether organic or non-organic, whether of biological, non-biological, chemical or non-chemical origin, and irrespective of cause, basis, or inducement). This includes, but is not limited to, psychoses, neurotic disorders, schizophrenic disorders, affective disorders, personality disorders, and psychological or behavioral abnormalities associated with transient or permanent dysfunction of the brain or related neurohormonal systems. (This is intended to include disorders, conditions and illnesses classified on Axes I and II in the current edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, Washington, D.C.) SAMPLE Mental Health and Substance Abuse Management Program refers to utilization management, benefits administration, and provider network activities administered by or on behalf of CareFirst BlueChoice to ensure that mental health and Substance Abuse services are Medically Necessary and provided in a cost-effective manner.
Mental Health and Substance Abuse Services. Members, a designated representative, or a provider on behalf of the Member may contact the MHSA by telephone, letter, or online to request a review of an initial determination concerning a claim or service. Members may contact the MHSA at the telephone number provided below. If the telephone inquiry to the MHSA’s Customer Service Department does not resolve the question or issue to the Member’s satisfaction, the Member may submit a grievance at that time, which the Customer Service Representative will initiate on the Member’s behalf. The Member, a designated representative, or a provider on behalf of the Member may also initiate a grievance by submitting a letter or a completed “Grievance Form”. The Member may also submit the grievance to the MHSA online by visiting xxxx://xxx.xxxxxxxxxxxx.xxx. 0-000-000-0000 Blue Shield of California Mental Health Service Administrator
Mental Health and Substance Abuse Services in a Residential Treatment facility are limited to a combined maximum of 60 days per Calendar Year.
