In addition, children enrolled in our Article 29-I Voluntary Foster Care Agency program (VFCA) are also eligible for the services and supports available through Children & Family Services. Learn more about VFCA here.
IMPORTANT NOTICE FOR PROVIDERS: Understanding How Adverse Childhood Experiences Affect Patients’ Health Across the Lifespan
Adverse Childhood Experiences (ACEs) are stressful or traumatic events, such as neglect and/or violence during childhood. ACEs are strongly related to brain development and a wide range of health problems throughout a person’s lifetime and may include, but are not limited to, physical or sexual abuse, domestic violence, living in poverty, death of a caregiver, exposure to discrimination, or living in a household with someone with mental illness, substance use disorder, or who has experienced incarceration. Read what ACEs research shows here.
HIV SNP HARP-eligible members are eligible for BH HCBS services. Learn more about our HIV SNP benefits and services here.
Many Behavioral Health resources are available to help providers make sound decisions regarding patients’ mental health and substance use issues. Below are some of the screenings and guidance providers can utilize.
|Utilization Management – Coming Soon|
|Care Management – Coming Soon|
Several factors impact whether a service or procedure is covered under a member’s benefit plan. Medical and behavioral health policies and clinical utilization management (UM) and clinical practice guidelines are resources that help us determine if a procedure is medically necessary. These documents are available below to you as a reference when interpreting claim decisions for our members.
Our updated Provider Manual is available here.
MetroPlusHealth is committed to supporting you with the tools you need to serve your patients — our members.
CLICK HERE TO VIEW OUR BEHAVIORAL HEALTH FAQS
Our training materials and calendar can be found below.
Providers can register here to attest that they have viewed the training materials for behavioral health.
Providers can also visit our Good4You Health Library, where a robust collection of articles and other tools to support your patients’ physical, mental, and emotional wellbeing can be found.
For those times when getting to a doctor is not easy, MetroPlusHealth members and their dependents under age 18 can also use our Virtual Visit telehealth program, offering free 24/7 telehealth visits with board-certified or licensed providers, including emergency medicine trained medical doctors and psychiatrists, social workers, and addiction counselors.
Learn more about Virtual Visit to see if it can be of use to your MetroPlusHealth patients.
Our Member Services team is always here to help, too.
Member Services is available Monday through Saturday, 8:00AM to 8:00PM at 1-800-303-9626.
After hours, Sundays, and holidays, you will be connected to our 24/7 Customer Service Hotline.
After hours, our Behavioral Health Crisis partner, Vibrant Emotional Health, can be reached at 1-866-728-1885.
Useful Contact Information: