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Your mental health benefit for POS members <br />South • Area <br />Outpatient Services <br />(Participating Providers) <br />• You can choose from any of the Magellan <br />Behavioral Health (MBH) participating providers <br />for mental health services. These providers are listed <br />in your Humana Participating Provider Directory. <br />• Complete mental health and substance abuse <br />treatment services are provided by MBH providers <br />at a minimal cost to you. <br />• Lifestyle Management Programs are also offered by <br />MBH as a covered benefit, e.g., Smoking Cessation, <br />Stress Management, and Weight Management. <br />Emergency services are available 24- hours -a -day; <br />7- days -a -week. <br />• Copayments and deductibles are waived for <br />outpatient services obtained through MBH providers; <br />no claim forms need to be filled out. <br />• There is no predetermined limit on the number of <br />visits to MBH therapists. <br />Outpatient services <br />(Nonparticipating Providers) <br />• You may choose a licensed mental health provider <br />who is not participating with MBH. However, <br />you will be responsible for the copayments and <br />deductibles as shown on your Humana "Schedule <br />of Benefits." Only medically necessary services <br />are covered. <br />FL- 65168 -BC 9/99 <br />• If you choose a nonparticipating provider for <br />outpatient treatment and require more than three (3) <br />visits, there will be a review process between your <br />treating provider and MBH. The provider will <br />advise MBH of the diagnosis and of the current <br />and recommended treatment plan. This process <br />results in better planning between you and the <br />provider and also allows for prompt payment. <br />Inpatient Services <br />(Precerti cation is required for all liospital admissions.) <br />• Psychiatric and substance abuse (detoxification) <br />admissions must be precertified to guarantee <br />coverage by your insurance. MBH's clinical staff <br />evaluates these admissions for medical necessity. <br />• MBH psychiatrists and psychologists coordinate <br />and oversee hospital treatment. <br />• MBH arranges intensive post- discharge aftercare <br />and any other appropriate treatment for patients <br />leaving the hospital. <br />• Regular copayments and limits for inpatient <br />services apply, as shown in your Humana "Schedule <br />of Benefits" <br />For more information or to schedule <br />an appointment please call: <br />Magellan <br />1�ehal, oml Health <br />1- 800 - 741 -1017 <br />