Mental health and Substance Use Disorder treatment services for members on Washington medical plans
Classification of Mental Health and SUD treatment and access standard
Mental health and Substance Use Disorder treatment services are characterized as specialty services when provided by behavioral and/or mental health professionals. This means that you must be able to access mental health or substance use disorder treatment services within 15 business days according to Washington law.
How an enrollee can find in-network mental health and substance use disorder treatment and services in their service area
You can find in-network providers by visiting our Provider Directory, available online at http://phppd.providence.org/ or calling Customer Service at 1-800-878-4445 to get information about a mental or behavioral health provider’s participation with Providence Health Plan and your benefits.
Steps an enrollee may take if they cannot access services in the required timelines
If you are having trouble making an appointment please call 1-800-878-4445 to speak with an intake specialist who will help you identify your needs and, if needed, facilitate an individualized appointment search.
How enrollees may file a complaint with WA OIC
If you would like to file a complaint with the Washington state Office of the Insurance Commissioner you may contact them at www.insurance.wa.gov or call 1-800-562-6900.
- Disciplinary action for failure to meet network access standards (no action against Providence Health Plan) (link coming soon)
- Washington Office of the Insurance Commissioner annual access standards and consumer complaints report (link coming soon)
Resources for persons experiencing a mental health crisis
- Suicide Prevention Hotline
The Suicide Prevention Hotline is 800-273-8255.
- Emergency Resources
If this is an emergency or you think you may harm yourself, call 911.
Resources for Substance Use Disorders
Additional information regarding behavioral health services and resources are available to Providence Health Plan members via Live and Work Well. To access these resources, Providence Health Plan members sign into myProvidence located at https://myprovidence.com. From there, members click on the behavioral health link located on the benefits tab.