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How do Members access my treatment services?
This varies. In some plans, Members access your services through a Provider Directory. Other plans required the Member to first call PMHM to obtain a treatment referral. When PMHM refers a patient to you, you will receive a letter with the patient’s identifying information, along with a specified number of treatment visits. PMHM will provide the patient with your contact information and he or she will call you to make an appointment. To obtain the patient’s benefits or to get more information, call 800-776-4357.
I have heard about PMHM’s “Professionally Guided Care.” What is it?
PMHM’s management program is different from other managed care companies. Whereas many managed care firms use nurse reviewers to make decisions about the type and amount of treatment to authorize, PMHM uses doctorate level Psychologists. A PMHM Psychologist reviewer will work closely with you to monitor the patient’s care, perhaps requesting testing and other information not required with other firms. Also, if you are having difficulty with treatment on a given patient, you may call and get a second opinion from the PMHM Psychologist.
How do I request a treatment extension?
Information will be included with your initial Treatment Authorization. If you have misplaced this information, please call PMHM at 800-776-4357.
How do I make a referral to a different Provider?
All Provider referrals must be handled through PMHM. Just contact the Patient Relations Coordinator (PRC) who made your initial Treatment Authorization.
Mail claims to:
- PMHM
- 401 E. Douglas, Suite 505
- Wichita, KS 67202
What do I do if one of my patient’s claims is denied?
You may appeal this decision by requesting an appeal in writing from PMHM. In your correspondence please provide all pertinent information such as the Member’s identifying information, the patient’s name and address and also the provider’s information. You may send your appeal request to: Preferred Mental Health Management, LLC, 401 E. Douglas, Suite 505, Wichita, KS 67202.
What type of multi-lingual services does PMHM offer?
PMHM has Spanish language capabilities for patients from the time of the initial call, continuing through the referral process. In the event that other languages are needed, PMHM has 24-hour access to a comprehensive language translation service. Utilizing this service, PMHM is able to access the appropriate translator within five minutes of the initial call. This translation service enables PMHM to effectively communicate with and meet the service needs of all of its non-English-speaking Covered Members. PMHM also has many multi-lingual Providers across the nation, and will make every effort to customize its Network to include Providers with foreign language capabilities for a given location.
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