Behavioral Health

To find out if your participating masters level clinician (or therapist), psychologist or psychiatrist is contracted:

• Visit the MHN website for the most up-to-date listing OR
• Contact MHN at 1-800-663-9355, Monday through Friday, 8:00 a.m. to 8:00 p.m. Pacific Time

Continuity of Care

If you, or a covered family member, are currently receiving behavioral health treatment, and your provider is not contracted with MHN, there are actions you can take to ensure you can continue to receive uninterrupted care.

• Speak with your provider about joining the MHN network. Providers interested in contracting with MHN should contact MHN Provider Relations.
• Find a new masters level clinician (or therapist), psychologist or psychiatrist by calling MHN at 1-800-663-9355, Monday through Friday, 8:00 a.m. to 8:00 p.m. PT, or by searching Find a Provider online.

You and your covered family members can use behavioral health benefits for medically necessary behavioral health services, as well as treatment for substance abuse. These benefits include:

• Sessions with masters level clinicians (or therapists), psychologists or psychiatrists.
• Treatment in clinical settings:
  • Care for a few hours a day, several days a week, which is called "Intensive Outpatient Treatment."
  • 24-hour care, which is called "inpatient treatment."
  • Follow-up treatment and aftercare.

You will also have access to telehealth for behavioral health providers like therapists and psychiatrists. Behavioral telehealth involves providing a range of services including psychiatric evaluations, therapy, patient education, and medication management through video conferencing. If you are interested in behavioral telehealth, you may inquire about participating providers in the MHN network. Behavioral telehealth offers convenient and readily-accessible behavioral health services on demand.

Please refer to the Evidence of Coverage booklet for more details.

2021 – Blue & Gold HMO EOC (PDF)

MHN reviews the proposed treatment before you receive care. This is referred to as "pre-service review". MHN requires preauthorization for the following:

• Psychological and neurological testing.
• Treatment more intense than routine outpatient visits but that do not require an overnight stay.
• Treatment at a hospital or other overnight care facility (referred to as "inpatient treatment"), except in an emergency. (If you need emergency inpatient treatment, you or a family member or your doctor or hospital must call MHN within 24 hours of admission. We'll make sure that your benefits are in place and assign a case manager to offer support.)

If you have questions about whether or not you will need preauthorization, please contact the MHN Customer Service team at 1-800-663-9355 Monday through Friday, 8:00 a.m. to 8:00 p.m. PT.

Concurrent review is designed to ensure that you always receive care in the most appropriate (least restrictive and most cost effective) setting. An MHN care manager reviews suggested inpatient treatment or alternate levels of care before you receive services and will review your care on a regular basis for the duration of your treatment.

When MHN is unable to perform pre-service or concurrent review – for example in an emergency – we will review treatment after it has occurred before approving benefits. Emergency care will be authorized as long as it meets the "prudent layperson standard." This standard is based on what a reasonable person with no clinical training would likely think, having observed the symptoms and concluded that emergency treatment was necessary.