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Outpatient Services

Members and/or practitioners are encouraged to contact MHN to verify benefits and eligibility, but MHN does not require authorization for routine outpatient services, such as psychotherapy and medication management. 

MHN does retrospective review on routine outpatient treatment using a population based model that looks at provider practice patterns and treatment that is at variance with MHN's expected treatment norms. MHN is committed to the quality of our members' treatment experience and our outpatient review process reflects this focus.

Psychological and neuropsychological testing is a covered service in some benefit plans and does require prior authorization by MHN. Other services such as alternate levels of care, Intensive Outpatient Programs, Partial Hospital Programs, Day Treatment or Outpatient De-toxification also require prior authorization.

For questions or to obtain services requiring prior authorization, it is recommended that you contact MHN utilizing the number on the back of the member ID card. For additional information on the utilization management policies for outpatient services, please review the discussion found in the Practitioner Manual.

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