INPATIENT AND INTERMEDIATE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES:
If you need inpatient or intermediate level mental health or substance abuse services, including crisis evaluations, crisis stabilization services and partial hospitalization/day treatment:
If you are an HMO or EPO member, your Designated Facility (listed on your ID card) must authorize all inpatient and intermediate level mental health and substance abuse services. If you do not have a Designated Facility identified, call your PCP who will arrange for your care.
If you are a POS member, please contact any of the Designated Facilities listed below to receive coverage for covered services at the authorized level of benefits. You also may go to a facility outside of the network, but you will be covered for covered services at the unauthorized level of benefits. USFHP members: Please call Tufts Health Plan at 800-208-9565.
If you are a PPO member, call the PPO Customer Service line at (800) 423- 8080 to determine your provider network. If your network is the Tufts Health Plan Designated Facility network please contact any of the Designated Facilities listed below to receive coverage for covered services at the in-network level of benefits. You receive coverage for covered services at the out-of-network level of benefits if you choose to receive care from a hospital that is not a Designated Facility.
If you are a member in a Select Network plan, Tufts Health Plan will only pay for services performed by providers who participate in our Select Network. Please see the applicable benefit document for detailed information.
The list of Designated Facilities is subject to change. If you are unsure about the status of a Designated Facility, please call the Tufts Health Plan Mental Health Department at 800-208-9565.
|
