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<table border="0" cellspacing="0" cellpadding="0"> <tr> <td colspan="2" width="581" align="left"><img src="/images/header/member/memInfo.gif" height="105" width="557" border="0" alt="Member Information & Forms"></td> </tr> <tr> <td width="31"><img src="/images/pixel.gif" alt="space" width="31" height="21"></td> <td rowspan="2" valign="top"> <table width="558" border="0" cellspacing="0" cellpadding="1"> <tr> <td><img src="/images/pixel.gif" alt="space" width="1" height="3"></td> </tr> <tr> <td><span class="HeaderText">Access the information and forms you need for coverage, claims and privacy. Plus, take our online survey and let us know how we can improve our services to you.</span></td> </tr> </table> <img src="/images/pixel.gif" alt="space" width="525" height="1"> </td> </tr> <tr> <td width="31"><img src="/images/pixel.gif" alt="space" width="1" height="50"> </td> </tr> </table>
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Out-of-Network Claims
If you are an MHN member using out-of-network benefits, use our CMS (HCFA)-1500 form to submit your claim.

Straight Line Claims Research & Review
Complete our research and review form to report any issues with your claim. You may submit this form online or fax to our MHN office.

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Life Management Survey
If you recently had a consultation through MHN's EAP, please take a moment to complete our short survey. Your feedback will help us improve our services to you.

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Member Privacy
Maintaining our members' trust and confidence is a top priority. Learn about our strict policies for the collection, use and disclosure of your personal medical information.

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Member Rights & Responsibilities
Learn about your rights and responsibilities as an MHN member.

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California Grievances & Appeals
Review the steps involved in our grievance and appeal process.

加利福尼亞州冤情申訴與上訴      Quejas y Apelaciones en California
Straight Line Financial Incentive & Conflict of Interest Disclaimers
All MHN clinical staff members are required to adhere to the following standards, assuring that there is no conflict of interest or inappropriate financial incentive(s) associated with the delivery of care.

Straight Line Related Links
Find additional information on mental illnesses, depression and other emotional health issues.

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Quality Improvement Initiatives
This section is designed to provide you valuable information on a variety of topics including coordination of care, member satisfaction and what to do after psychiatric hospitalization.

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Understanding Therapy
MHN is here to help you get acquainted with the process and find the best fit for your needs.

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