Behavioral Health Benefits definition

Behavioral Health Benefits means benefits for services to treat behavioral health conditions that are classified as behavioral health conditions based on generally recognized independent standards of current mental health, including the most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), or the most current version of the International Classification of Diseases (ICD).
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Behavioral Health Benefits means insurance coverage of mental health treatment and services and substance use disorder treatment and services.
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Behavioral Health Benefits is the specific portion of the Benefits Contract that references mental health and substance abuse services. These services must be provided by a behavioral health practitioner and for a diagnosis (Axis I/II) listed in the most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
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Examples of Behavioral Health Benefits in a sentence

  • If the Enrollee contacts an In-Network Provider before contacting the Behavioral Health Benefits Manager, the In-Network Provider will assess the condition, develop a preliminary treatment plan, and then contact the Behavioral Health Benefits Manager for treatment authorization.

  • If services for treatment of a substance abuse or addition condition are needed, the Enrollee must contact the Behavioral Health Benefits Manager directly for assessment and referral to an In- Network Provider.

  • Behavioral Health coverage in the PPO is administered by a Behavioral Health Benefits Manager through a network of qualified In-Network Providers to promote the delivery of care at the right time and in the most appropriate settings.

  • At the Plan’s discretion, most non-emergent services must be approved in advance by the Behavioral Health Benefits Manager to determine the appropriateness of the treatment.

  • The Contractor may cover additional services necessary to comply with the requirements for parity in Behavioral Health Benefits in 42 C.F.R. Part 438, Subpart K; however, the Contractor must provide advance written notice to and receive prior written approval from the EOHHS Managed Care Director when it believes this requirement is triggered.

  • Please see your Schedule of Benefits for more information on your Behavioral Health Benefits, or call AllWays Health Partners’ GIC Customer Service.

  • DBHR contract monitoring staff ensure the provision of 24/7 hotlines in each PIHP service area in three different areas:*EQRO audits the PIHPs to ensure PIHPs monitor for the provision of 24/7 hotlines in their service area.*DBHR contract monitoring staff ensure the accuracy and provision of the PIHP 24/7 hotlines annually when updating the Behavioral Health Benefits Booklet and the websites.

  • That discussion is supplemented by the section entitled "Precertification” in the Behavioral Health Benefits area of the SPDs (see page 71 of the HRA SPD and page 93 of the HSA SPD).

  • The Contractor shall cover Behavioral Health Benefits in a manner that is no more restrictive than the coverage for Medical/Surgical Benefits.

  • Any of the Individual’s Rights and Protections as listed in the Washington Medicaid Behavioral Health Benefits Booklet published by HCA.

Related to Behavioral Health Benefits

  • Behavioral health means the promotion of mental health, resilience and wellbeing; the treatment of mental and substance use disorders; and the support of those who experience and/or are in recovery from these conditions, along with their families and communities.

  • Behavioral health services means mental health services as

  • Behavioral health administration or "BHA" means

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79

  • Health Benefits means health maintenance organization, insured or self-funded medical, dental, vision, prescription drug and behavioral health benefits.

  • Behavioral health disorder means either a mental disorder

  • Essential Health Benefits means, under section 1302(b) of the Patient Protection and Affordable Care Act, those health benefits to include at least the following general categories and the items and services covered within the categories: ambulatory patient services; Emergency Services; hospitalization; maternity and newborn care; mental health and substance abuse disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

  • Behavioral health treatment means counseling and treatment programs, including applied behavior analysis, that are:

  • Behavioral therapy means interactive therapies derived from evidence-based research, including applied behavior analysis, which includes discrete trial training, pivotal response training, intensive intervention programs, and early intensive behavioral intervention.

  • Retiree Health Plan means an "employee welfare benefit plan" within the meaning of Section 3(1) of ERISA that provides benefits to individuals after termination of their employment, other than as required by Section 601 of ERISA.

  • Health benefits plan means a benefits plan which pays or

  • Mental Health Worker means an individual that assists in planning, developing and evaluating mental health services for Clients; provides liaison between Clients and service providers; and has obtained a Bachelor's degree in a behavioral science field such as psychology, counseling, or social work, or has two years of experience providing client related services to Clients experiencing mental health, drug abuse or alcohol disorders. Education in a behavioral science field such as psychology, counseling, or social work may be substituted for up to one year of the experience requirement.

  • Gap medical benefits means the benefits (if any) payable in respect of medical expenses that are less than, greater than or equal to the schedule fee, provided always that the medical expenses relate to a professional service that:

  • Health plan or "health benefit plan" means any policy,

  • Medical Benefits means the monthly fair market value of benefits provided to the Employee and the Employee’s dependents under the major medical, dental and vision benefit plans sponsored and maintained by the Company, at the level of coverage in effect for such persons immediately prior to the Employee’s termination of employment date. The “monthly fair market value” of such benefits shall be equal to the monthly cost as if such persons elected COBRA continuation coverage at such time at their own expense.

  • Pharmacy benefits management means the administration or management of prescription drug

  • Mental health services means interventions designed to provide the maximum reduction of mental disability and restoration or maintenance of functioning consistent with the requirements for learning, development and enhanced self-sufficiency. Services shall include: a. Assessment means a service activity, which may include a clinical analysis of the history and current status of a beneficiary’s mental, emotional, or behavioral disorder, relevant cultural issues and history, Diagnosis and the use of testing procedures.

  • Mental health waiver means a waiver of the two-month waiting period for an upgrade from ‘Restricted services’ to ‘Included services’ for in-hospital psychiatric treatment in accordance with Division 78 of the Private Health Insurance Act 2007 for an eligible member. The mental health waiver can only be used once in a member’s lifetime across any private health insurer.

  • Community mental health program means all mental health

  • School health services means health services provided by a qualified school nurse or other qualified person that are designed to enable a child with a disability to receive FAPE as described in the child’s IEP.

  • Allied Health Professional means a person registered as an allied health professional with the Health Professions Council;

  • Health and Human Services or “HHS” includes HHSC and DSHS.

  • Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.

  • Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.

  • Medical history means information regarding any:

  • Mental health services provider means an individual, licensed or unlicensed, who performs or purports to perform mental health services, including a: