Q: What services does MHNet provide to the health plan or the employer?
A: MHNet Behavioral Health provides a customized solution to each of our clients. Therefore, there is not one answer to this question. Please refer to the contract with MHNet for specifics. These are some of the standard services available:
· Disease Management
· Preventive Health Initiatives
· Mental Health and Substance Abuse Case Management
· Mental Health and Substance Abuse Utilization Review
· Quality Assurance
· Utilization Forecasting
· Employee Assistance Programs
· WorkLife Programs
· Claims Administration
Q: Who do I contact when I have a question regarding the services provided by MHNet?
A: Please contact the region that manages the health plan or employer’s members. The Regional Executive Director will gladly assist you with any questions.
Q: Do you provide any collaborative Preventive Health Programs?
A: MHNet has worked with many clients to provide a behavioral health component to their prevention or disease management programs. Some examples include: Diabetes, Congestive Heart Failure and Depression in the Elderly.
Q: Do you provide any consultation regarding benefit design?
A: MHNet has 25 years experience managing behavioral health benefits and can help you determine which benefit design is right for you and your membership. Please contact the Regional Executive Director to explore this opportunity.
Q: I need a special report, can MHNet help me?
A: MHNet’s proprietary information gateway called ODIS®—On Demand Information System—is a fully relational, data warehouse and retrieval system that stores every field of information including eligibility, benefits authorizations, provider data, quality improvement activities, case management data, and claims data. The system allows us to report any combination of data elements in any format and medium. MHNet has a full complement of standard reports covering access, availability, care of members, utilization, satisfaction, claims, and credentialing. MHNet will work with you to set up flexible, customized reporting. Ad hoc reports are available and are usually completed within 24 hours.
Q. How does MHNet protect a member’s personal information?
A: MHNet will always request the member’s permission (or that of a legal guardian) before releasing any information about a member to an unauthorized party. Additionally, MHNet does numerous other things to protect their personal health information
· All MHNet employees, when hired, sign an agreement to keep information private.
· Confidential material is only shared with those employees who have a need to know.
· Confidential material is kept in a secure and locked location.
· MHNet evaluates the methods used by providers to maintain privacy of information.
· MHNet does not release details about your care to your employer without your written approval.
· When MHNet uses data to improve quality, information is reported on a group basis. Personal details are not reported.
· Identifiable information is protected and coded.
· Access to computerized information is protected by passwords.
Q: Who can make a complaint?
A: A complaint can be made by an enrollee, enrollee advocate (guardian/parent of a child or a competent adult or agency that has legal custody of an individual) practitioner, provider (facility or program), health plan or government agency.
Q: How do I file a complaint?
A: A health plan or employer may make a complaint either verbally or in writing. You should contact the appropriate MHNet regional office to file your complaint.
Q: What is an appeal?
A: An appeal is any request by the member or provider for reconsideration of a decision.
Q: Does MHNet or the health plans manage the appeal?
A: This varies depending upon the contract with the health plan. Should MHNet be delegated appeal processing we will gladly manage the appeal process. In many cases, the health plan maintains this responsibility and MHNet assists the health plan with the behavioral health appeal.