Behavioral Health Services. Behavioral health services include the evaluation, management, and treatment for a mental health or substance use disorder condition. For the purpose of this plan, substance use disorder does not include addiction to or abuse of tobacco and/or caffeine. Mental health or substance use disorders are those that are listed in the most updated volume of either: • the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association; or • the International Classification of Disease Manual (ICD) published by the World Health Organization. This plan provides parity in benefits for behavioral healthcare services. Please see Section 10 for additional information regarding behavioral healthcare parity. For inpatient hospital and intermediate care services described below, network providers are responsible for submitting notification of admission to us. When these services are received from non-network providers you are responsible for ensuring notification of admission has been provided to us. In many cases, the non-network provider may submit the notification on your behalf. However, prior to receiving these services, please check with your provider to ensure notification has been made. Inpatient
Appears in 35 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
