Q: What is MHNet Behavioral Health?
A: MHNet is a behavioral health care organization chosen by health plans or employers to coordinate behavioral health care benefits.
Q: Does the enrollee need a referral from their primary care physician to see a mental health provider?
A: Whether a referral is needed is determined by the specific plan benefits on a plan-by-plan basis. Please contact your MHNet regional office to verify if a referral is needed in your area.
Q: How do I obtain a referral or authorization?
A: You can contact MHNet by calling the telephone number for mental health services on the enrollee’s ID card.
Q: Can you answer questions regarding the enrollee’s medical insurance?
A: No, MHNet only administers and has information on behavioral health care benefits. Please contact the customer service number on the enrollee’s insurance card regarding any medical benefits.
Q. How does MHNet protect the enrollee’s personal information?
A: MHNet will always request the enrollee’s permission (or that of a legal guardian) before releasing any information about the enrollee or their care to an unauthorized party. Additionally, MHNet does numerous other things to protect members’ 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 enrollees’ care to employers without enrollee 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: What are your guidelines regarding psychological testing?
A: Coverage for different types of services is determined by the enrollee's specific plan benefits and must be pre-certified to be covered. A psychological testing form needs to be completed and sent to MHNet for approval of hours/tests. Approval will be phoned to the practitioner.
Q: Who can make a complaint?
A: A complaint can be made by an enrollee, enrollee advocate (guardian/parent, of a child or incompetent 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: You can make a complaint either verbally or in writing. Please contact your MHNet regional office to file your complaint.
Q: Why am I receiving an Outpatient Treatment Report (OTR) from MHNet?
A: MHNet believes that the best treatment requires coordination between behavioral health and medical providers. MHNet requests an OTR from providers and then forwards that OTR to Primary Care Physicians when appropriate. This process ensures that the PCP has the latest information on risk factors and medications.