Member Rights and Responsibilities

As a member of MHN, you have certain rights and responsibilities related to your mental health and substance use disorder benefits. For this reason, we have developed guidelines for you to follow during the access and treatment process. We recommend that you familiarize yourself with the rights and responsibilities below in order to receive optimal care and service.

As an MHN managed behavioral health plan member, you have the right to:

  • Receive information regarding MHN services and clinical guidelines
  • Call MHN for assistance 24 hours a day, 365 days a year
  • Call 911 in an emergency
  • Receive prompt, competent and courteous treatment from all MHN staff and practitioners
  • Ask questions about and see documentation of your practitioner's credentials and experience
  • Discuss appropriate or medically necessary treatment options, regardless of cost or benefit coverage and obtain a clear explanation of MHN's criteria for determining medical necessity
  • Confidentiality of your medical records to the extent protected by state and federal law
  • Obtain an explanation regarding legally required exceptions to confidentiality
  • Receive a clear explanation from your practitioner about the recommended treatment plan and length of treatment
  • Participate in decision-making regarding your treatment
  • Refuse or terminate treatment at any time
  • Be treated with respect and recognition of your dignity and need for privacy
  • Receive an explanation from your practitioner of any consequences that may result from refusing treatment
  • Obtain a clear explanation of MHN's reasons for determining that care is not medically necessary
  • Appeal a denial
  • File complaints with MHN, the State Department of Insurance, the Department of Managed Health Care, the State Department of Health and Human Services or any other applicable regulatory body
  • Suggest ways to improve MHN's member rights & responsibilities policies and procedures
  • Receive a complete explanation of your fees and charges
  • Receive a clear explanation of your financial responsibility when you use out-of-network providers
  • Be free from balance billing by your practitioner 

As a member, it is your responsibility to:

  • Furnish information needed by MHN and your practitioner which allows us to provide proper treatment 
  • Actively participate in developing mutually agreed-upon treatment goals and strategies for achieving those goals
  • Follow the plans you have agreed upon with your practitioner
  • Cancel appointments within the guidelines described by MHN or your practitioner
  • Read your Evidence of Coverage or other material outlining your behavioral health benefits
  • Ask questions to ensure your understanding of covered services, limitations and any authorization procedures, and comply with the rules and conditions as stated
  • Pay any copayments at the time of service
  • Demonstrate courtesy and respect to your practitioner, the practitioner's staff and MHN employees, and expect similar treatment in return

Access to Health Net Out-of-Network Claims Information

If you are a Health Net Member looking for information about Health Net's and MHN's out-of-network claim policies, procedures, services and the rights you may be entitled, visit Health Net's main website. (If this is your first time visiting Health Net's website, you will be required to register.)