MEMBER HANDBOOK - BMC HealthNet Plan
MEMBER HANDBOOK - BMC HealthNet Plan
MEMBER HANDBOOK - BMC HealthNet Plan
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of benefits paid from a third person<br />
or entity, such as an insurer.<br />
Urgent Care – Medical care required<br />
quickly to prevent a worsening<br />
of health due to symptoms<br />
that a prudent lay person would<br />
believe are not an Emergency but<br />
do require medical attention. urgent<br />
Care does not include Routine<br />
Care.<br />
Utilization Management – The<br />
process by which <strong>BMC</strong> <strong>HealthNet</strong><br />
<strong>Plan</strong> reviews the clinical necessity,<br />
appropriateness, or efficiency of<br />
covered services, procedures, or<br />
settings.<br />
37<br />
<strong>BMC</strong> <strong>HealthNet</strong> <strong>Plan</strong> Member Services Department<br />
8:00 a.m. – 6:00 p.m., (Eastern Time) Monday-Friday 1.888.566.0010 (English and other languages) • 1.888.566.0012<br />
(en Español) • 1.866.765.0055 (TTY/TDD for hearing impaired) • 1.800.421.1220 (relay operator for hearing impaired) •<br />
1.888.217.3501 (Behavioral Health: mental health and substance abuse questions 24 hours a day/7 days a week managed by<br />
Beacon Health Strategies) • 1.888.727.9441 (Behavioral Health TTY/TDD for hearing impaired) • 1.800.973.6273 (Nurse Advice<br />
Line) • Web Site www.bmchp.org • www.beaconhealthstrategies.org (Behavioral health)<br />
MassHealth Customer Service<br />
8:00 a.m. – 5:00 p.m., Monday-Friday<br />
1.800.841.2900 • 1.800.497.4648 (TTY/TDD for hearing impaired)
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