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  • Behavioral Health Services

    In this chapter, you'll find our policies and procedures for mental health and substance abuse services, including:

    • Prior approval procedures
    • Post-discharge protocols
    • Mental Health Parity Law
    • Health Homes

     

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    Glossary terms found on this page:

    Conditions that affect thinking and the ability to figure things out that affect perception, mood and behavior.

    Conditions that affect thinking and the ability to figure things out that affect perception, mood and behavior.

    A type of health benefit plan that allows enrollees to go outside the health plan's provider network for care, but requires enrollees to pay higher out-of-pocket fees when they do. Also called Point of Service.

    The process of obtaining advanced approval of coverage for a health care service or medication. The request for services is reviewed to assess medical necessity and appropriateness of elective hospital admissions and non-emergency outpatient services before the services are provided. Also called pre-authorization or pre-certification or pre-determination.

    The use of one or more drugs for purposes other than those for which they are prescribed or recommended.

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