HAP Balanced Living blog

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Behavioral health

HAP has a dedicated team that matches our members with the best – and most appropriate – behavioral health services. The Coordinated Behavioral Health team also monitors the member’s care throughout their treatment.

When we talk about behavioral health, we’re referring to both mental health and chemical dependence (addiction) problems.

Getting care

Not sure what help you need?

Your primary care physician is the best place to start. Your PCP will be able to offer advice about problems such as mild depression. They’ll ask a few simple screening questions to determine if you should be referred to a behavioral health professional.

Coordinating care with your PCP

Keep your PCP aware of any treatment you receive.

To ensure you get the best results with few complications, you may be asked to sign a release for your PCP. This will allow your behavioral health provider and primary care physician to exchange important, appropriate information about your care.

Referrals and prior authorization

You do not need referrals or prior authorization for the following:

  • Hospital admissions
  • Emergency services
  • Outpatient, routine care

You need prior authorization for autism related care, neuropsychological and psychological testing.

Choosing a mental health or substance abuse specialist

Depending on your specific plan, you may be able to make an appointment with a mental health or substance abuse specialist yourself.

Our managed care specialist - licensed social workers, limited licensed psychologist and licensed professional counselor – can explain your behavioral health coverage and tell you if you’ll need a referral. They can also help you find a provider. Call (800) 444-5755 to speak with a managed care specialist.

You can also use our Find a Doctor or Facility tool to choose a mental health or substance abuse specialist.

Wait-time standards

HAP has established wait-time standards for behavioral health services to ensure you get the care you need within an appropriate period of time. You can expect to receive care according to these guidelines:

  • Emergency situations require immediate intervention to prevent serious self-harm or harm to others. An example of this would be someone threatening suicide or violence.
  • Emergency services should be sought immediately by going to the nearest emergency room. If needed, your local police department can be contacted for assistance by dialing 911.
  • Urgent services must be provided within 72 hours of the request being made. The definition of urgent is a sudden condition that requires treatment but is not life threatening, such as persistent depression.
  • Routine services must be provided within 10 days of the request being made. Routine is defined as treatment that does not require immediate attention but does require an appointment (e.g., mild depression).

What to do in an emergency

HAP covers treatment in any emergency room in the event that you or your family member needs to be seen without delay. We also cover any emergency services necessary to screen and stabilize members without precertification of emergency services in cases where:

  1. A person (acting reasonably) believes an emergency exists.
  2. A provider or other authorized representative acting through the organization has authorized emergency services.

If you need help getting the care you need, contact Coordinated Behavioral Health Management at (800) 444-5755.

Contact our Coordinated Behavioral Health team

The Coordinated Behavioral Health team clinical staff is comprised of a licensed social worker, a limited license psychologist, a licensed professional counselor and a psychiatrist.

  • All clinical staff are licensed and required to have at least five years of experience in treating patients with a mental health condition, substance abuse addictions or both.
  • The licensed social worker, limited licensed psychologist and licensed professional counselor must have a minimum of a master's degree in a behavioral medicine-related field.

You can reach us at (800) 444-5755. We’re available Monday through Friday from 8 a.m. to 5 p.m.

In the event of an urgent situation, a clinical case manager is available 24/7 by calling (800) 444-5755.

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