mercy maricopa integrated care

Dch v chm sc sc khe ton din

Mercy Maricopa Integrated Care S tay hi vin 2016 www.MercyMaricopa.org

http:www.MercyMaricopa.org

Thng tin v RBHA Dch v hi vin Mercy Maricopa a ch gi th: 602-586-1841 hoc 1-800-564-5465; Mercy Maricopa Integrated Care (TTY/TDD) 711 4350 E. Cotton Center Blvd., Bldg. D Gi lm vic: 24 gi mt ngy, 7 ngy mt tun Phoenix, AZ 85040 S gi trong trng hp cp cu: 911

Trang web: www.MercyMaricopa.org ng dy tr gip v khng hong Facebook: www.Facebook.com/MercyMaricopa sc khe hnh vi: Twitter: @MercyMaricopa 602-222-9444 hoc 1-800-631-1314 (TTY/TDD) 1-800-327-9254

S gi trong trng hp cp cu: 911

Thng tin c nhn v thng tin lin h

S ID hi vin ca ti __________________________________________________________

Tn S in thoi

PCP (Nh cung cp dch v chm

sc chnh) ca ti ___________________________ ___________________________

Bnh vin ___________________________ ___________________________

Nh thuc ___________________________ ___________________________

Nhn vin qun l trng hp ___________________________ ___________________________

Bc s tm thn hoc y t ca ti ___________________________ ___________________________

Cc dch v c bao tr theo Tiu 19 v Tiu 21 c cung cp thng qua T/RBHA s c thanh ton theo hp ng vi AHCCCS, c quan Medicaid ca Tiu bang. Nhng ngi iu kin tham gia cc chng trnh ny i khi c gi l iu kin tham gia AHCCCS.

C hiu lc t ngy 1 thng 4 nm 2014, Mercy Maricopa Integrated Care bt u hot ng vi t cch l C quan qun l sc khe hnh vi khu vc cho Ht Maricopa. Kinh ph cho dch v c cung cp thng qua hp ng vi C quan dch v y t Arizona/ Ban dch v sc khe hnh vi (Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS)) v H thng bnh n chi ph chm sc sc khe ca Arizona (Arizona Health Care Cost Containment System (AHCCCS)). y l thng tin sc khe chung v khng thay th cho t vn hoc dch v chm sc m qu v nhn c t nh cung cp dch v ca mnh. Hy lun hi nh cung cp dch v v cc nhu cu chm sc sc khe ca chnh qu v.

Cp nht thng 10 nm 2015

www.MercyMaricopa.org AZR-15-08-03

http:www.MercyMaricopa.orgwww.Facebook.com/MercyMaricopahttp:www.MercyMaricopa.org

Mercy Maricopa Integrated Care i

S tay hi vin

Mercy Maricopa Integrated Care ii

1

Cch s dng s tay ny Phn I, bt u t trang 7, m t cc dch v chm sc sc khe hnh vi ca qu v c cung cp thng qua Mercy Maricopa Integrated Care (Mercy Maricopa). y l cc dch v m hi vin mc Khuyt tt v pht trin (Developmentally Disabled (DD)) v Chm sc cp tnh AHCCCS theo Medicaid c th nhn c. Nhng ngi c xc nh l mc bnh tm thn nghim trng (serious mental illness (SMI)) cng c th iu kin nhn nhng dch v ny.

Phn II, bt u t trang 62, m t cc dch v y t c bao tr thng qua Mercy Maricopa. Cc dch v kt hp, dch v chm sc y t v sc khe hnh vi ch c cung cp cho nhng ngi c xc nh l mc SMI. Hi vin mc DD (Khuyt tt v pht trin) v Chm sc cp tnh AHCCCS s tip tc c chm sc vt l tr liu thng qua Hp ng v Chm sc cp tnh k ca h.

Gii thiu v thut ng, nh ngha v ti nguyn trong S tay hi vin ny

S tay hi vin ny s dng mt s t ng c th kh hiu. gip qu v hiu r hn, chng ti b sung thng tin ny v phn nh ngha chm sc sc khe ton din ca qu v.

Trong Phn I, mt phn c tn Cc thut ng s nh ngha mt s t ng v sc khe hnh vi. Phn Cc thut ng bt u t trang 59 ca s tay ny.

Trong Phn II, cng c mt phn c tn Cc nh ngha v sc khe. Phn ny s nh ngha cc t ng c s dng m t dch v chm sc sc khe y t. Phn Cc nh ngha v sc khe bt u t trang 90 ca s tay ny. Ngoi ra, c mt phn c tn Cc nh ngha v dch v chm sc thai sn c th gip ph n, gia nh v ngi i din ca h hiu r hn mt s ngn ng c s dng trong sc khe ca ph n. Phn Cc nh ngha v chm sc thai sn bt u t trang 92 ca s tay ny.

Vui lng c s tay ny. S tay ny cho qu v bit: Cc quyn v ngha v ca qu v vi t cch l hi vin Cch nhn cc dch v chm sc sc khe Cch nhn c tr gip ln lch hn Dch v no c bao tr v dch v no khng c bao tr

S tay ny sn c cc dng vn bn v ghi m khc. Vui lng c phn c tn Nhn thng tin bng ngn ng v nh dng m qu v hiu c, trang 7, bit thm thng tin.

Phn I v Phn II ca s tay ny c mt s loi ti nguyn, bao gm cc t chc cung cp h tr cho cng ng sc khe hnh vi trn trang 55-58, nh cung cp dch v chm sc sc khe theo thang gi linh ng/chi ph thp ti Ht Maricopa v cc vng ca Ht Pinal trn trang 89 v cc ti nguyn v thng tin v sc khe trn trang 83-88.

Mercy Maricopa Integrated Care

Mercy Maricopa Integrated Care 2

3

Mc lc

Cch s dng s tay ny................................................................... 1 Gii thiu v thut ng, nh ngha v ti

nguyn trong S tay hi vin ny ............................................... 1

Cho mng qu v n vi Mercy Maricopa ................... 5 Thng tin lin h ca Dch v hi vin ca

Mercy Maricopa ...................................................................................... 6 Th nhn dng hi vin..................................................................... 6

Phn I: Cc dch v chm sc sc khe hnh vi ca

Mercy Maricopa Integrated Care.............................................. 7

m bo chm sc ph hp vi vn ha.............................. 7 Nhn thng tin bng ngn ng v nh dng

m qu v hiu c ............................................................................ 7 Cch nhn cc dch v chm sc sc khe

hnh vi t Mercy Maricopa.............................................................. 8 iu kin nhn dch v chm sc sc

khe hnh vi ............................................................................................. 8 Xy dng nhm lm sng................................................................ 8 Mng li nh cung cp ................................................................... 9 C s cp cu tm thn dnh cho ngi ln....................10 Chn nh cung cp............................................................................16 Lin h vi ngi qun l trng hp ca qu v ...........16 Giy gii thiu n mt nh cung cp khc ......................16 Chp thun dch v v quyn nhn thng bo...............16 Thc hnh tt nht trong dch v chm

sc sc khe hnh vi .........................................................................19 Cc dch v chm sc sc khe hnh vi

c bao tr............................................................................................19 Cc dch v iu tr khng hong v cp cu...................19 Cc dch v chm sc sc khe hnh vi sn c ...............19 Khon bao tr thuc (cc dch v nh thuc) ...................30 Vn chuyn n cuc hn chm sc sc khe

hnh vi (a n).................................................................................30 Xt nghim HIV/AIDS........................................................................30

Khon bao tr dch v dnh cho cc

nhm c bit .......................................................................................30 Khon bao tr dch v dnh cho ngi

M Da ..................................................................................................30 Khon bao tr dch v dnh cho thnh

phn dn s c bit.........................................................................31 Khon bao tr dch v cho cc hi vin

khng iu kin tham gia AHCCCS ..................................32 Chp thun iu tr, bo mt v ch th trc....................33 Chp thun iu tr.............................................................................33 Thng tin sc khe hnh vi ca ti c mang tnh ring t khng? ...........................................................33 Cc trng hp ngoi l v bo mt ......................................34 Ch th trc.............................................................................................34 Thanh ton cho cc dch v chm sc

sc khe ca qu v ............................................................................35 Cc khon ng thanh ton ca AHCCCS...........................35 Cc khon ng thanh ton ca ADHS/DBHS..................38 Medicare v bo him y t thng qua

Federal Health Insurance Marketplace...................................38 Khon bao tr ca Medicare.........................................................38 Chng trnh Tr cp thu nhp hn ch

(Low Income Subsidy (LIS))............................................................40 Quyn v trch nhim v sc khe hnh

vi ca hi vin ........................................................................................40 Ngi i din c ch nh hoc

ngi bnh vc.....................................................................................42 Khiu ni, than phin v khng co ca hi vin............43 Khiu ni v dch v chm sc ca hi vin.......................43 Than phin/Yu cu iu tra dnh cho

nhng hi vin c xc nh mc bnh

tm thn nghim trng...................................................................44 Thng bo hnh ng .....................................................................45 Khng co ca hi vin....................................................................45


4 Mercy Maricopa Integrated Care

Khng co dnh cho nhng hi vin iu

kin tham gia AHCCCS theo Title 19/21 ................................46 Khng co dnh cho nhng ngi c xc

nh l mc bnh tm thn nghim trng..........................48 Khng co dnh cho nhng hi vin khng

c xc nh l mc bnh tm thn nghim

trng v iu kin nhng khng theo

Tiu 19/21..........................................................................................49 Tm nhn ca Arizona v vic cung cp cc

dch v chm sc sc khe hnh vi.........................................50 Thay i v quy m gia nh, a ch hoc

tnh iu kin ..................................................................................53 Gian ln, lng ph v lm dng chng trnh ....................54 Ngun lc a phng v quc gia cho cng

ng dch v chm sc sc khe hnh vi ...........................55 Cc thut ng v chm sc sc khe hnh vi...................59

Phn II: Cc dch v y t ca Mercy Maricopa ..............62 Quyn v trch nhim ca hi vin .........................................62 Chuyn dch v chm sc sc khe th cht

sang chng trnh AHCCCS ..........................................................62 Cch nhn cc dch v y t t Mercy Maricopa ...............63 Bc s chm sc chnh (PCP) c ch nh

ca qu v..................................................................................................64 C s nha khoa......................................................................................65 Giy gii thiu y t...............................................................................66 Cho php y t.........................................................................................66 Cc loi dch v chm sc: Thng k,

Khn cp v Cp cu.........................................................................66 Chm sc sau gi hnh chnh .....................................................67 Khon bao tr ngoi khu vc.......................................................68 Cc dch v y t c bao tr ......................................................69 Cc dch v y t khng c bao tr ......................................70 Cc dch v b gii hn v loi tr* ...........................................70 Cc dch v EPSDT...............................................................................72

Dch v nha khoa.................................................................................73 Dch v nhn khoa..............................................................................73 Thm khm khe mnh ..................................................................73 Khon bao tr thuc (cc dch v nh thuc) ...................73 Dch v vn chuyn y t (a n)...........................................75 Cc dch v dnh cho ph n .....................................................75 Cc dch v thai sn ...........................................................................76 Cc dch v k hoch ha gia nh ..........................................77 Cc dch v dnh cho nhu cu chm

sc sc khe c bit........................................................................77 Xt nghim HIV/AIDS........................................................................78 Ngun tip liu xt nghim bnh tiu ng..................78 Thit b chnh hnh..............................................................................78 Thanh ton cho cc dch v ca qu v .................................78 Cc khon ng thanh ton, ng bo

him v tin khu tr Medicare..................................................78 Cc trng hp ngoi l v khng co i

vi Medicare Phn D..........................................................................78 Nu qu v c bo him y t khc.............................................79 Nhn ha n dch v......................................................................79 Than phin v khng co ca hi vin ..................................79 Than phin ca hi vin..................................................................79 T chi, ct gim, tm dng hoc chm

dt dch v v yu cu khng co ............................................80 Thng bo hnh ng (NOA)......................................................80 Quy trnh khng co ..........................................................................81 Yu cu phng n gii quyt nhanh ....................................81 Li khuyn nhanh v t chi........................................................82 Nh cung cp dch v chm sc sc khe

theo thang gi linh ng/chi ph thp

Ht Maricopa......................................................................................82 Dch v nha khoa l ph thp ti Ht Maricopa ................89 Cc nh ngha v sc khe..........................................................90 Cc nh ngha v dch v chm sc thai sn ...................92

5

Cho mng qu v n vi Mercy Maricopa Ti Arizona, cc dch v c cung cp thng qua m hnh Chm sc c qun l. iu ny c ngha l nhng ngi nhn c dch v chm sc sc khe chn mt nh cung cp thuc mng li v c mt s ngha v nht nh (xem Quyn v ngha v v sc khe hnh vi ca hi vin v Quyn v ngha v ca hi vin bit thm thng tin). Cc c quan qun l sc khe hnh vi khu vc (Regional Behavioral Health Authorities (RBHA)) v Cc c quan qun l sc khe hnh vi khu vc dnh cho b lc (Tribal Regional Behavioral Health Authorities (TRBHA)) phi m bo rng cc dch v chm sc sc khe c sn cho hi vin ca mnh. Da vo ni qu v sinh sng, RBHA ca qu v l Mercy Maricopa.

Bn cnh vic m bo s sn c ca cc dch v, Mercy Maricopa phi gim st cht lng ca cc dch v chm sc sc khe c cung cp cho hi vin, s dng dch v ph hp v chi ph lin quan n vic cung cp nhng dch v cn thit.

tm hiu thm v h thng cung cp dch v chm sc sc khe hnh vi ca Arizona, qu v c th truy cp trang web ca S dch v y t Arizona/Ban dch v chm sc sc khe hnh vi ti www.azdhs.gov/bhs/.

Kt ni qu v vi dch v chm sc C nhiu phc li v dch v sn c cho qu v. Qu v cng c quyn tip cn nhiu nh cung cp dch v chm sc sc khe v ti nguyn cng ng. Thng tin trong cun s tay ny gii thch v cc phc li ca qu v v cch s dng cc phc li . Thng tin ny cng cho qu v bit vic cn lm trong trng hp khn cp v gii thch quyn v ngha v ca qu v. Vui lng c k ti liu ny.

Cc dch v v ngun h tr sng khe mnh Chng ti c mt y cung cp cho qu v s h tr qu v cn, khi qu v cn n. Cc nhu cu v th cht, hnh vi v x hi nh hng n sc khe tng th ca qu v. l trng tm ca chng ti - sc khe ton din ca qu v. p ng nhu cu ca qu v, chng ti phi tm hiu v qu v. Chng ti gip qu v t c mc tiu v sc khe th cht v hnh vi ca mnh. V chng ti thu ht tt c nhng i tng xung quanh qu v tham gia. i tng ny bao gm gia nh, bn b, nh cung cp v cng ng ca qu v. Bt k ai thuc bt k tui, gii tnh, thu nhp, chng tc hay tn gio no u c th gp vn v sc khe hnh vi. iu c th nh hng n suy ngh, cm xc v hnh ng ca qu v. i khi, vn ny nh. Nhng nhiu khi, n li l mt vn nghim trng hn v ko di hn. D theo cch no th cm thy tt hn lun l iu c th. Nu qu v ang phi i mt vi vn v sc khe hnh vi, qu v khng ch c mt mnh. Chng ti lun sn sng gip .

Kt ni ti a phng ca qu v Mercy Maricopa Integrated Care l RBHA cho Vng dch v a l (GSA) 6, bao gm ton b Ht Maricopa v mt phn nh pha bc ca Ht Pinal. Ngoi s tay hi vin ny, chng ti cn c rt nhiu ti nguyn dnh cho qu v, bao gm Danh mc nh cung cp, th thng bo hi vin hng qu, Hng dn ti nguyn cng ng v Hng dn gip gia nh la chn. C th tm thy nhng ti nguyn ny v cc ti nguyn khc trn trang web ca chng ti, www.MercyMaricopa.org.

Mercy Maricopa l chng trnh chm sc sc khe phi li nhun ti a phng do Mercy Care Plan v Maricopa Integrated Health System (MIHS) ti tr.

Mercy Care Plan l chng trnh phi li nhun ca Arizona cung cp cch tin hnh chm sc i mi c qun l ca Medicaid t nm 1985. Mercy Care Plan do Dignity Health v Carondelet Health Network ti tr. MIHS l h thng chm sc sc khe cng cng. H thng ny ng vai tr l mng li an ton v chm sc sc khe cho cc c dn ca Ht Maricopa trong hn 135 nm.

Mercy Maricopa Integrated Care do Aetna qun l. Aetna cng qun l chng trnh cho Mercy Care Plan.

Nu qu v mun tm hiu thm v thng tin trong S tay hi vin ny, vui lng lin h vi Dch v hi vin ca Mercy Maricopa.


http:www.MercyMaricopa.orgwww.azdhs.gov/bhs


Thng tin lin h ca Dch v hi vin ca Mercy Maricopa

Dch v hi vin sn sng gip gii p cc thc mc ca qu v. Dch v hi vin c th gip qu v: Tm hiu v cc dch v m qu v c th nhn c Tm nh cung cp, bao gm nhng nh cung cp s cung cp dch v sau gi lm vic thng thng Nhn c cu tr li cho cc thc mc ca qu v Khiu ni hoc cung cp phn hi tch cc v dch v

Dch v hi vin ca Mercy Maricopa lun sn sng phc v 24 gi mt ngy, 7 ngy mt tun. lin h vi chng ti, qu v c th gi n s 6025861841 hoc 18005645465; (TTY/TDD) 711. Qu v cng c th gi email n [email protected]. Vn phng ca chng ti t ti 4350 E. Cotton Center Blvd., Building D, Phoenix, AZ 85040.

Th ID Mercy Maricopa ca qu v c s in thoi lin h vi dch v chm sc sc khe hnh vi v lm dng dc cht. Cc dch v c ch nh cho nh cung cp ni qu v sinh sng. Nu qu v c thc mc hoc cn tr gip v vic nhn cc dch v chm sc sc khe hnh vi, vui lng gi n s trn th ca qu v.

Th nhn dng hi vin Bo v th ID ca qu v! Khng a th cho bt k ai khc ngoi tr nhng ngi cung cp dch v chm sc sc khe ca qu v. Nu qu v cho thu, bn hoc a th ID ca mnh cho bt k ai khc, qu v c th mt quyn li AHCCCS v/hoc hnh ng php l c th c thc hin. Nu qu v mt tnh iu kin, ng vt b th ID hi vin. Qu v s khng c cp th khc nu iu kin tr li.

mailto:[email protected]

7

Phn I: Cc dch v chm sc sc khe hnh vi ca


m bo chm sc ph hp vi vn ha

Cc truyn thng, di sn, tn gio/tn ngng, ngn ng v cc kha cnh khc ca cuc sng m qu v v gia nh ca qu v coi trng nht xc nh qu v l ngi nh th no v l mt phn trong vn ha ca qu v. Mercy Maricopa khuyn khch cc nh cung cp tm hiu vn ha ca mi c nhn hiu, giao tip v i x tt hn vi nhng ngi m Mercy Maricopa phc v. Nh cung cp ca qu v s yu cu qu v chia s thng tin v vn ha vi h h c th gip qu v xc nh k hoch iu tr tt nht cho qu v hoc thnh vin trong gia nh ca qu v. Qu v cn gip nh cung cp ca mnh hiu c iu g l quan trng i vi qu v v gia nh qu v v iu ny s gip iu chnh cc dch v p ng cc nhu cu c th ca qu v.

Hy nh trao i vi nh cung cp ca qu v nhng g qu v v gia nh qu v cho l quan trng nht khi xc nh vic iu tr ca qu v v tho lun v cc mc tiu ca qu v. iu ny bao gm yu cu nh cung cp ca qu v hoc Mercy Maricopa cung cp thng tin bng ngn ng v nh dng m qu v hiu c. bit thm thng tin v bn dch ting Ty Ban Nha, thng dch bng ngn ng k hiu, cc thit b b tr v thng tin dng bn in cho ngi b suy gim th lc, vui lng xem phn ca s tay c tiu Nhn thng tin bng ngn ng v nh dang m qu v hiu c. Nu nh cung cp ca qu v hiu c mc tiu ca qu v l g, h c th h tr qu v tt hn t c cc mc tiu .

Mercy Maricopa phi hp vi cc nh cung cp ca mnh hiu hn v cc nn vn ha khc nhau v cung cp dch v theo cch ph hp vi vn ha. Qu v c th xem Chng trnh ph hp v vn ha ca Mercy Maricopa trc tuyn ti www.mercymaricopa.org/providers/training/culture.

Nhn thng tin bng ngn ng v nh dng m qu v hiu c

Cc dch v bin dch v thng dch vin Qu v c th yu cu tr gip t Mercy Maricopa m bo: Thng tin di dng vn bn sn c ngn ng ca qu v hoc c th c dch sang ngn ng ca qu

v qu v c th hiu thng tin Qu v c th tm cc nh cung cp ni ngn ng ca qu v Nu qu v iu kin nhn cc phc li theo AHCCCS v/hoc qu v l ngi c xc nh l mc SMI,

th cc dch v thng dch vin s c cung cp min ph cho qu v.

Lin h vi 6025861841 hoc 18005645465; (TTY/TDD) 711 yu cu dch v bin dch hoc thng dch.

Thng dch vin ngn ng k hiu v cc thit b b tr Nu qu v b khim thnh hoc nng tai, qu v c th yu cu nh cung cp ca mnh cung cp cc thit b b tr hoc sp xp mt thng dch vin ngn ng k hiu p ng cc nhu cu ca qu v. Nh cung cp ca qu v phi cung cp nhng dch v ny.

Thit b b tr bao gm bn ghi c h tr bng my tnh, cc ti liu dng vit, thit b hoc h thng tr thnh, thuyt minh v ph cng cc phng php hu hiu khc nhm cung cp cc ti liu di dng m thanh cho nhng ngi b mt thnh lc.

Cc thng dch vin bng ngn ng k hiu l cc chuyn gia c chuyn mn c chng nhn cung cp dch v thng dch, thng l bng Ngn ng k hiu Hoa K, cho ngi khim thnh. tm danh sch cc thng dch vin ngn ng k hiu v bit cc lut lin quan n ngh thng dch vin Tiu bang Arizona, vui lng truy cp vo y ban ngi khim thnh v ngi nng tai Arizona ti www.acdhh.org hoc gi n s 602-542-3323 (V); 602-364-0990 (TTY); 800-352-8161 (V/TTY); 480-559-9441 (in thoi video).


http:www.acdhh.orgwww.mercymaricopa.org/providers/training/culture


Thng tin dng bn in dnh cho hi vin b suy gim th lc Nu qu v b suy gim th lc v qu v cn s tay hi vin ny hoc cc ti liu khc, chng hn nh thng bo v mu chp thun, dng ch in c ln, hy lin h vi nh cung cp ca qu v hoc Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 nhn ti liu nh dng thay th. Qu v cng c th truy cp www.MercyMaricopa.org/members/mmic/handbook xem s tay bng cc ngn ng khc.

Cch nhn cc dch v chm sc sc khe hnh vi t Mercy Maricopa

iu kin nhn dch v chm sc sc khe hnh vi Cc hi vin sau iu kin nhn dch v chm sc sc khe hnh vi: Nhng ngi iu kin tham gia AHCCCS thng qua Title 19 (Medicaid) hoc Title 21 Nhng ngi c xc nh l mc bnh tm thn nghim trng Thnh phn dn s c bit iu kin nhn cc dch v c ti tr thng qua cc khon tr cp

trn gi ca lin bang

Title 19 (Medicaid; cng c th c gi l AHCCCS) l bo him dnh cho cc c nhn, tr em v gia nh c thu nhp thp. Bo him ny chi tr cc dch v y t, nha khoa (cho tr em t 21 tui tr xung) v dch v chm sc sc khe hnh vi.

Title 21 (cng c th c gi l AHCCCS) l bo him dnh cho tr em di 19 tui khng c bo him v khng iu kin nhn cc phc li theo Title 19. Bo him ny chi tr cc dch v y t, nha khoa v dch v chm sc sc khe hnh vi.

Mercy Maricopa hoc nh cung cp ca qu v s t cc cu hi cho qu v gip xc nh liu qu v c iu kin nhn cc phc li ca AHCCCS khng. Nu c, h c th gip qu v hon tt AHCCCS. Nu qu v khng iu kin tham gia AHCCCS Mercy Maricopa hoc nh cung cp ca qu v c th gip qu v np n ng k bo him y t trn Federal Health Care Marketplace.

Bnh tm thn nghim trng l chng ri lon tm thn nng v dai dng nhng ngi t 18 tui tr ln. Cc c nhn c th b suy gim n mc h khng th li cng ng m khng cn iu tr v/hoc dch v. Mng li ng ph khng khong, mt nh cung cp k hp ng vi Mercy Maricopa, s xc nh v bnh tm thn nghim trng khi c giy gii thiu/yu cu.

Xy dng nhm lm sng Nhng ngi iu kin nhn cc dch v chm sc sc khe hnh vi thng qua AHCCCS c ch nh n T/RBHA t ti ni h sinh sng. Tuy nhin, ngi M Da c ch nh n mt TRBHA, c quyn chn nhn cc dch v ca h t RBHA hoc TRBHA. Qu v c ch nh n Mercy Maricopa v qu v sng trong khu dch v ca Mercy Maricopa. Qu v s tip tc nhn cc dch v t Mercy Maricopa, tr khi qu v chuyn sang khu vc khc ni Mercy Maricopa khng cung cp dch v. Nhng ngi khng iu kin tham gia AHCCCS s c ghi danh vi mt T/RBHA nhn cc dch v chm sc sc khe hnh vi. Vic ghi danh vi T/RBHA cng da trn ni sinh sng ca mt ngi.

Sau khi c ch nh n Mercy Maricopa, qu v s pht trin mt nhm nhm gip qu v xc nh nhu cu v sc khe hnh vi ca mnh v nhn cc dch v chm sc sc khe hnh vi. Nhng nhm ny c gi l nhm lm sng hay c th hn l Nhm tr em v gia nh hoc Nhm phc hi dnh cho ngi ln. Qu v cng c th chn hoc s c ch nh, da trn ni qu v sinh sng, n mt trung tm iu tr sc khe hnh vi. Trung tm iu tr l ni qu v nhn cc dch v chm sc sc khe tm thn ngoi tr chnh. Mt s trung tm iu tr cng cung cp cc dch v chm sc sc khe th cht.

cuc hn ban u, qu v s gip xc nh qu v mun ai trong Nhm lm sng ca mnh. Sau nhm ny s cng vi qu v nghin cu cc mc tiu ca qu v, thc hin nh gi lin tc v ln k hoch dch v. Hi vin ca nhm s da vo cc chuyn gia chm sc sc khe hnh vi ang phi hp cng qu v v ngi qu v mun tr thnh mt phn trong nhm ca qu v. Nhm c th bao gm cc thnh vin gia nh, ngi gim h, bn b, tng l cng nhng ngi h tr khc t cng ng. Thng thng, vic nh gi c thc hin

www.MercyMaricopa.org/members/mmic/handbook


cuc hn u tin s cha hon thin. Qu v s phi hp vi cc hi vin trong nhm ca mnh tip tc quy trnh nh gi . iu ny cho php qu v v nhm ca qu v lin tc xem xt tin v nhu cu qu v nhn c dch v chm sc tt nht. K hoch iu tr, cn c gi l K hoch dch v c nhn (ISP), phi bao gm tt c cc dch v m qu v cn, chng hn nh nh , t vn v i li. K hoch iu tr phi c cp nht ti thiu hng nm theo nhu cu ca qu v.

Nhm tr em v gia nh Nhm tr em v gia nh (CFT) l mt nhm ngi bao gm, ti thiu l, a tr v gia nh tr, i din sc khe hnh vi v bt k ngi no c vai tr quan trng trong cuc sng ca tr m c tr v gia nh xc nh v mi tham gia. V d: nhm thnh vin c th bao gm gio vin, thnh vin i gia nh, bn b, i tc ng h gia nh, nh cung cp dch v chm sc sc khe, hun luyn vin, nh cung cp ti nguyn cng ng, i din t cc lin kt tn gio nh nh th, gio ng Do Thi, nh th Hi Gio hoc i din t cc h thng dch v khc nh Ban an ton tr em Arizona (Arizona Department of Child Safety (DCS)) hoc Ban ph trch v khuyt tt pht trin (Division of Developmental Disabilities (DDD)), v.v. Quy m, phm vi v mc tham gia ca cc hi vin trong nhm c xc nh bi nhng mc tiu c thit lp cho tr, nhu cu ca gia nh trong vic cung cp cho tr v cc ti nguyn cn thit pht trin mt k hoch dch v hiu qu. Nhm tr em v gia nh c th m rng v pht trin khi cn thit gip tr thnh cng.

Nhm phc hi dnh cho ngi ln Mt nhm ngi lm vic cng nhau tham gia tch cc vo qu trnh nh gi cho mt c nhn, ln k hoch dch v v cung cp dch v bng cch lm theo chn Nguyn tc ch o cho cc H thng v dch v chm sc sc khe hnh vi hng n s phc hi dnh cho ngi ln. Ti thiu, nhm ny phi bao gm c nhn , ngi gim h ca c nhn (nu c), ngi bo cha (nu c ch nh) v i din sc khe hnh vi tiu chun. Nhm ny cng c th bao gm cc thnh vin gia nh ca ngi c ghi danh, nh cung cp dch v sc khe th cht, sc khe tm thn hoc dch v x hi, i din hoc cc c quan khc phc v c nhn , cc chuyn gia i din cho cc nguyn tc lin quan n nhu cu ca c nhn hoc nhng ngi khc do c nhn c ghi danh xc nh.

Qu v s c th thay i nhm ca mnh, nu mun, h tr tt nht cho nhu cu ca qu v v t c cc mc tiu m qu v t ra.

Mng li nh cung cp Mng li nh cung cp l mt nhm cc nh cung cp phi hp vi Mercy Maricopa v sn sng cung cp cc dch v chm sc sc khe hnh vi. Mercy Maricopa s gip qu v chn mt nh cung cp thuc mng li nh cung cp. Nu qu v mun chn nh cung cp da trn s tin li, a im hoc s u tin v vn ha, vui lng cho Dch v hi vin ca Mercy Maricopa bit. Qu v s cn phi lin h vi nh cung cp ln lch, thay i hoc hy cc cuc hn ca qu v. Qu v cng c th lin h vi Mercy Maricopa nu qu v mun c h tr ln lch, thay i hoc hy cc cuc hn ca mnh.

Nu qu v khng hi lng vi nh cung cp hin ti ca mnh, hy gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 tho lun v cc ty chn sn c khc.

C th tm thy danh sch tt c cc nh cung cp sn c, a im, s in thoi v ngn ng ni ca h trc tuyn ti www.MercyMaricopa.org/findprovider. Nu qu v khng c quyn truy cp vo Internet ti nh, dch v Internet min ph thng c cung cp ti cc th vin. Qu v cng c th nhn min ph mt bn sao dng giy cho danh sch nh cung cp bng cch gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Mt s nh cung cp c th s khng nhn hi vin mi. tm hiu nh cung cp no trong mng li ca Mercy Maricopa khng nhn hi vin mi, hy lin h vi Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Qu v c th chn bt k bnh vin hoc c s no khc cho dch v chm sc cp cu. Tuy nhin, c mt s c s cp cu trong mng li ca Mercy Maricopa c th ph hp hn cho qu v. Cc c s ny bao gm:

www.MercyMaricopa.org/find-provider


C s cp cu tm thn dnh cho ngi ln

Trung tm chm sc sc khe tm thn khn cp Connections AZ Urgent Psychiatric Care Center (UPC) 1201 S. 7th Ave. Phoenix, AZ 85007 in thoi: 602-416-7600

Recovery Response Center West (RRC) 11361 N. 99th Ave. Peoria, AZ 85345 in thoi: 602-650-1212, nhn 2

Community Bridges Community Psychiatric Emergency Center (CPEC) 358 E. Javelina Ave. Mesa, AZ 85210 in thoi: 1-877-931-9142

Dch v iu tr khng hong ngi ln RI International Recovery Crisis Respite Program (RCRP) 11361 N. 99th Ave., Ste. 107 Peoria, AZ 85345

Trung tm gii c Community Bridges Central City Addiction Recovery Center (CCARC) 2770 E. Van Buren St. Phoenix, AZ 85008 in thoi: 1-877-931-9142

Community Bridges East Valley Addiction Recovery Center (EVARC) 560 S. Bellview Mesa, AZ 85204 in thoi: 1-877-931-9142

Bnh nhn ni tr b khng hong Southwest Behavioral Health Crisis Recovery Units I & II 1424 S. 7th Ave. Phoenix, AZ 85007 in thoi: 602-257-8970

Can thip khng hong gii hn thi gian Community Bridges West Valley Transition Point 824 N. 99th Ave. Avondale, AZ 85323 in thoi: 1-877-931-9142

Bnh nhn ngoi tr 24/7 Community Bridges West Valley Access Point 824 N. 99th Ave. Avondale, AZ 85323 in thoi: 1-877-931-9142

Theo di bnh tm thn 23 gi Banner Psychiatric Observation 575 E. Earll Dr. Scottsdale, AZ 85251 in thoi: 480-448-7600

St. Lukes Behavioral Health Center 1800 E. Van Buren St. Phoenix, AZ 85006 in thoi: 602-251-8535

Connections AZ Urgent Psychiatric Care Center (UPC) 1201 S. 7th Ave. Phoenix, AZ 85007 in thoi: 602-416-7600

Recovery Response Center West (RRC) 11361 N. 99th Ave. Peoria, AZ 85345 in thoi: 602-650-1212, nhn 2

Community Bridges Community Psychiatric Emergency Center (CPEC) 358 E. Javelina Ave. Mesa, AZ 85210 in thoi: 1-877-931-9142


Nu qu v KHNG phi l trng hp cp cu nhng cn dch v chm sc sau gi hnh chnh, vo cui tun hoc k ngh v qu v khng th i gp bc s ca mnh, qu v nn i ti c s chm sc khn cp c bao tr. Cc c s ny bao gm:

Phoenix Urgent Care Plus 1002 E. McDowell Rd., Ste. 120 Phoenix, AZ 85006 in thoi: 602-258-7051 Fax: 602-258-5638

FastMed Urgent Care 2301 N. 44th St. Phoenix, AZ 85008 in thoi: 602-808-8786 Fax: 602-808-8704

Cigna Medical Group Urgent Care 3003 N. 44th St. Phoenix, AZ 85012 in thoi: 602-282-9848 Fax: 602-282-5486

Good Night Pediatrics Central Phoenix 3600 N. 3rd Ave., Ste. B Phoenix, AZ 85013 in thoi: 602-412-4033 Fax: 602-412-4032

Express Urgent CarePhoenix 333 W. Thomas Rd, Ste. 100 Phoenix, AZ 85013 in thoi: 602-368-1400 Fax: 602-368-3939

Quick Visit Urgent CarePhoenix 2040 W. Bethany Home Rd., Ste. 105 Phoenix, AZ 85015 in thoi: 602-850-0000 Fax: 602-346-9999

FastMed Urgent Care 5201 N. 19th Ave., Ste. 100 Phoenix, AZ 85015 in thoi: 602-795-1411 Fax: 602-242-3519

NextCare Urgent CareThomas 1701 E. Thomas Rd., Ste. A104 Phoenix, AZ 85016 in thoi: 1-888-381-4858 Fax: 602-277-9360

FastMed Urgent Care 3302 W. Thomas Rd., Ste. 10 Phoenix, AZ 85017 in thoi: 602-233-2900 Fax: 602-233-3897

NextCare Urgent CareArcadia 4730 E. Indian School Rd., Ste. 211 Phoenix, AZ 85018 in thoi: 602-354-3491 Fax: 602-595-8567

FastMed Urgent Care 2423 W. Dunlap Ave., Ste. 150 Phoenix, AZ 85021 in thoi: 602-216-6862 Fax: 302-216-9745

FastMed Urgent Care 401 E. Bell Rd., Ste. 18 Phoenix, AZ 85022 in thoi: 602-368-1403 Fax: 602-368-1413

Quick Visit Urgent Care Center and Walkin Clinic 1930 W. Thunderbird Rd., Ste. 102 Phoenix, AZ 85023 in thoi: 602-850-0000 Fax: 602-346-9999

Valle Del Sol Urgent Care 4338 W. Thomas Rd., Ste. 116-117 Phoenix, AZ 85031 in thoi: 623-385-7950 Fax: 623-792-1232

Urgent Care ExtraPhoenix 3247 E. Bell Rd., Ste. PB-1 Phoenix, AZ 85032 in thoi: 602-996-1316 Fax: 602-569-0905

NextCare Urgent CareGreenway 3229 E. Greenway Rd., Ste. 102 Phoenix, AZ 85032 in thoi: 1-888-381-4858 Fax: 602-788-3284


Scottsdale Healthcare Urgent Care Plus 13843 N. Tatum Blvd., Ste. 1 Phoenix, AZ 85032 in thoi: 480-323-3366 Fax: 480-323-3399

FastMed Urgent Care 8260 W. Indian School Rd., Ste. 1 Phoenix, AZ 85033 in thoi: 623-846-7122 Fax: 623-846-7027

NextCare Urgent Care 5920 W. McDowell Rd. Phoenix, AZ 85035 in thoi: 1-888-381-4858 Fax: 623-245-0439

Advantage Urgent Care 9515 W. Camelback Rd., Ste. 136 Phoenix, AZ 85037 in thoi: 602-530-6189 Fax: 602-548-2292

Express Urgent CareEstrella 9250 W. Thomas Rd., Ste. 100 Phoenix, AZ 85037 in thoi: 623-322-5900 Fax: 623-322-6667

West Valley Urgent CarePhoenix 4110 N. 108th Ave., Ste. 101 Phoenix, AZ 85037 in thoi: 623-218-0780 Fax: 623-218-0786

Good Night Pediatrics South Mountain 325 E. Baseline Rd. Phoenix, AZ 85040 in thoi: 602-824-4228 Fax: 602-276-1102

Jesse Owens Urgent Care 325 E. Baseline Rd. Phoenix, AZ 85040 in thoi: 602-824-4350 Fax: 602-824-5942

NextCare Urgent CareTatum 20950 N. Tatum Blvd., Ste. 190 Phoenix, AZ 85050 in thoi: 1-888-381-4858 Fax: 480-776-0026

Accu Care Urgent Care LLC 7041 N. 35th Ave. Phoenix, AZ 85051 in thoi: 602-336-0700 Fax: 602-336-0800

Mesa FastMed Urgent Care 835 W. University Dr. Mesa, AZ 85201 in thoi: 480-664-6007 Fax: 480-664-6017

Urgent Care Extra 1955 W. Guadalupe Rd., Ste. 101 Mesa, AZ 85202 in thoi: 480-207-2990 Fax: 480-838-1541

NextCare Urgent CareNorth Mesa 535 E. McKellips Rd., Ste. 101 Mesa, AZ 85203 in thoi: 1-888-381-4858 Fax: 480-615-4444

Cigna Medical Group 1840 S. Stapley Dr., Ste. 101 Mesa, AZ 85204 in thoi: 480-464-6969 Fax: 480-464-6979

Urgent Care ExtraMesa 1120 S. Gilbert Rd. Mesa, AZ 85204 in thoi: 480-558-5278 Fax: 480-558-5187

NextCare Urgent CareDana Landing 3130 E. Baseline Rd., Ste. 105 Mesa, AZ 85204 in thoi: 1-888-381-4858 Fax: 480-558-4922

NextCare Urgent Care 1066 N. Power Rd., Ste. 101 Mesa, AZ 85205 in thoi: 1-888-381-4858 Fax: 480-966-0566


Tempe Urgent Care ExtraTempe McClintock 3141 S. McClintock Rd., Ste. 1 & 2 Tempe, AZ 85282 in thoi: 480-389-3756 Fax: 480-491-1653

Urgent Care ExtraTempe Rural 6323 S. Rural Rd., Ste. 107 Tempe, AZ 85283 in thoi: 480-775-2657 Fax: 480-755-0290

FastMed Urgent Care 1804 W. Elliot Rd. Tempe, AZ 85284 in thoi: 480-456-0444 Fax: 480-456-0449

Urgent Care ExtraTempe Elliot 931 E. Elliot Rd., Ste. 115 Tempe, AZ 85284 in thoi: 480-389-5630 Fax: 480-491-2264

Scottsdale Urgent Care ExtraScottsdale 6501 E. Greenway Pkwy., Ste. 3-104 Scottsdale, AZ 85254 in thoi: 480-948-3314 Fax: 480-948-3588

PCMG Scottsdale Urgent Care 6990 E. Shea Blvd., Ste. 104 Scottsdale, AZ 85254 in thoi: 480-922-5437 Fax: 480-922-5438

Scottsdale Family and Urgent Care 9767 N. 91st St., Ste. 103 Scottsdale, AZ 85258 in thoi: 480-314-2200 Fax: 480-314-3455

NextCare Urgent CareShea 7425 E. Shea Blvd., Ste. 108 Scottsdale, AZ 85260 in thoi: 1-888-381-4858 Fax: 480-348-1059

Chandler Urgent Care ExtraChandler 3200 S. Gilbert Rd. Chandler, AZ 85286 in thoi: 480-471-6404 Fax: 480-219-4915

Gilbert Health First Urgent Care 888 S. Greenfield Rd., Ste. 101 Gilbert, AZ 85296 in thoi: 480-892-1300 Fax: 480-507-7477

Urgent Care ExtraGilbert Higley 1355 S. Higley Rd., Ste. 104 Gilbert, AZ 85296 in thoi: 480-840-6600

Urgent Care ExtraGilbert 3126 S. Higley Rd., Ste. 109 Gilbert, AZ 85297 in thoi: 480-436-8102 Fax: 480-209-1974

Glendale NextCare Urgent Care 10240 N. 43rd Ave., Ste. 3 Glendale, AZ 85302 in thoi: 1-888-381-4858 Fax: 623-742-2061

Cigna Medical Group 5891 W. Eugie Ave. Glendale, AZ 85304 in thoi: 602-588-6703 Fax: 602-588-6906

NextCare Urgent CareNorthern 9494 W. Northern Ave., Ste. 101 Glendale, AZ 85305 in thoi: 1-888-381-4858 Fax: 623-872-1018

Advantage Urgent Care 5410 W. Thunderbird Rd., Ste. 101 Glendale, AZ 85306 in thoi: 602-530-6189 Fax: 602-548-2292


Now Care Urgent Care Clinic 8251 W. Union Hills Dr., Ste. 140 Glendale, AZ 85308 in thoi: 623-875-7900 Fax: 623-875-7919

NextCare Urgent Care59th 18589 N. 59th Ave., Ste. 101 Glendale, AZ 85308 in thoi: 1-888-381-4858 Fax: 602-547-8700

Urgent Care ExtraPhoenix 4232 W. Bell Rd., Ste. C1 Glendale, AZ 85308 in thoi: 602-639-4535 Fax: 602-942-4717

PCMG NW Valley Urgent Care 20325 N. 51st Ave., Ste. 116 Glendale, AZ 85308 in thoi: 623-972-5437 Fax: 623-492-9420

West Valley Urgent Care 17218 N. 72nd Dr., Ste. 100 Glendale, AZ 85308 in thoi: 623-334-8670 Fax: 623-334-8675

Avondale Good Night Pediatrics Avondale 10320 W. McDowell Rd., Bldg. L Avondale, AZ 85323 in thoi: 623-643-9233 Fax: 623-643-9234

PCMG Southwest Valley Urgent Care 1665 N. Avondale Blvd. Avondale, AZ 85392 in thoi: 623-312-2000

NextCare Urgent CareMcDowell 13075 W. McDowell Rd., Ste. D106 Avondale, AZ 85392 in thoi: 1-888-381-4858 Fax: 623-547-0521

Sun City NextCare Urgent Care 98TH 9745 W. Bell Rd., Ste. 105 Sun City, AZ 85351 in thoi: 1-888-381-4858 Fax: 623-742-2985

Express Urgent Care 10249 W. Thunderbird Blvd., Ste. 300 Sun City, AZ 85351 in thoi: 623-889-7285 Fax: 623-889-7286

Tolleson Alliance Urgent Care 9897 W. McDowell Rd., Ste. 100 Tolleson, AZ 85353 in thoi: 623-474-2300 Fax: 480-505-3348

Surprise Advantage Urgent Care 14800 W. Mountain View Blvd., Ste. 190 Surprise, AZ 85374 in thoi: 602-530-6189 Fax: 602-548-2292

West Valley Urgent Care 14811 W. Bell Rd., Ste. 101 Surprise, AZ 85374 in thoi: 623-815-9073 Fax: 623-815-9201

Peoria Urgent Care Extra 7611 W. Cactus Rd. Peoria, AZ 85381 in thoi: 623-242-0049 Fax: 623-486-6642

We Care Urgent Care Centers 7615 W. Thunderbird Rd., Ste. 106 Peoria, AZ 85381 in thoi: 623-773-2273 Fax: 623-773-2274


NextCare Urgent CareSun City 20470 N. Lake Pleasant Rd., Ste. 102 Peoria, AZ 85382 in thoi: 1-888-381-4858 Fax: 623-825-0231

Good Night Pediatrics Northwest Valley 8801 W. Union Hills Dr., Bldg. A Peoria, AZ 85382 in thoi: 623-241-9026 Fax: 480-813-9601, 623-241-9027

Ht Pinal NextCare Urgent CareSouthern 2080 W. Southern Ave., Ste. A1 Apache Junction, AZ 85120 in thoi: 1-888-381-4858 Fax: 480-985-0173

NextCare Urgent CareFlorence 1683 E. Florence Blvd., Ste. 7 Casa Grande, AZ 85122 in thoi: 1-888-381-4858 Fax: 520-876-0801

Urgent Care Extra San Tan 40773 N. Ironwood Dr. San Tan Valley, AZ 85140 in thoi: 602-714-1271 Fax: 480-987-6566


Mng li ca Mercy Maricopa cng bao gm cc nh thuc, ni qu v c th mua toa thuc ca mnh. Mng li ny bao gm cc nh thuc CVS Caremark. Qu v c th tm thy danh sch cc nh thuc trn trang web ca Mercy Maricopa ti www.MercyMaricopa.org/findpharmacy.

Nu qu v i ti mt Nh thuc c trong danh sch ca Mercy Maricopa mua toa thuc nhng b t chi bi Nh thuc , vui lng gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Chn nh cung cp Mng li nh cung cp l mt nhm cc nh cung cp phi hp vi T/RBHA v sn sng cung cp cc dch v chm sc sc khe hnh vi. Mercy Maricopa s gip qu v chn mt nh cung cp thuc mng li nh cung cp. Nu qu v mun chn nh cung cp da trn s tin li, a im hoc s u tin v vn ha, vui lng cho Dch v hi vin ca Mercy Maricopa bit. Qu v s cn phi lin h vi nh cung cp ln lch, thay i hoc hy cc cuc hn ca qu v. Qu v cng c th lin h vi Mercy Maricopa nu qu v mun c h tr ln lch, thay i hoc hy cc cuc hn ca mnh. Nu qu v cn tr gip v vic ln lch cuc hn, hy lin h vi Dch v hi vin ca Mercy Maricopa.

Nu qu v khng hi lng vi nh cung cp hin ti ca mnh, hy lin h vi Dch v hi vin ca Mercy Maricopa tho lun v cc ty chn sn c khc.

Nu qu v ang nhn c cc dch v iu tr lm dng dc cht c ti tr bi iu tr v phng nga lm dng dc cht (Substance Abuse Block Grant (SABG)), qu v c quyn nhn cc dch v t mt nh cung cp m qu v khng phn i vi c im tn gio ca h. Nu qu v phn i vi c im tn gio ca nh cung cp dch v iu tr lm dng dc cht, qu v c th yu cu giy gii thiu n mt nh cung cp dch v iu tr lm dng dc cht khc. Qu v s c mt cuc hn vi nh cung cp mi trong vng 7 ngy k t khi yu cu giy gii thiu hoc sm hn nu tnh trng sc khe hnh vi ca qu v i hi. Nh cung cp mi phi sn c vi qu v v cung cp cc dch v iu tr lm dng dc cht tng t vi cc dch v m qu v nhn t nh cung cp u tin.

Lin h vi ngi qun l trng hp ca qu v Nu qu v cn gp ngi qun l trng hp ca mnh gia cc ln thm khm v bt k l do no, hy gi trc tip cho nh cung cp hoc phng khm ca qu v. Qu v c th c cu hi v dch v hoc cn trao i vi ngi qun l trng hp ca mnh v cch qu v ang thc hin. Qu v c th mun yu cu dch v mi hoc hi v ti nguyn cng ng. Nh cung cp c th gip kt ni qu v vi ngi qun l trng hp ca qu v. Dch v hi vin ca Mercy Maricopa cng c th gip kt ni qu v vi ngi qun l trng hp ca qu v. Vui lng cho gi cho chng ti theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Giy gii thiu n mt nh cung cp khc Qu v hoc nh cung cp ca qu v c th cm thy rng qu v cn dch v chm sc chuyn khoa t mt nh cung cp dch v chm sc sc khe hnh vi khc. Nu iu xy ra th nh cung cp s a cho qu v mt "giy gii thiu" i n mt nh cung cp khc cho dch v chm sc chuyn khoa

Qu v c th lin h vi Mercy Maricopa hoc nh cung cp ca qu v nu qu v cm thy cn giy gii thiu n dch v chm sc chuyn khoa.

Nhng ngi iu kin theo Title 19/21 c th nhn kin th cp. Theo yu cu ca ngi iu kin theo Title 19/21, Mercy Maricopa phi cung cp kin th cp t mt chuyn gia chm sc sc khe thuc mng li Mercy Maricopa hoc nu ngi khng thuc mng li T/RBHA, hy sp xp cho ngi nhn c kin th cp bn ngoi mng li, min ph. Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Chp thun dch v v quyn nhn thng bo Qu v v nh cung cp hoc nhm lm sng ca qu v s lm vic vi nhau a ra quyt nh v cc dch v m qu v cn. Cc dch v cp cu cn thit trong tnh trng y t cp cu khng cn c chp thun trc khi qu v c th nhn c cc dch v

http://www.mercymaricopa.org/find-pharmacy.If


Mt s dch v cn c chp thun trc khi qu v c th nhn cc dch v . V d nh cc trng hp nhp vin khng cp cu hoc cc trng hp khc chng hn nh: C s chm sc sc khe hnh vi ni tr C s chm sc sc khe hnh vi ngoi tr o to chm sc ti nh cho khch hng chm sc ti nh (HCTC) Xt nghim tm l v bnh hc thn kinh Liu php sc in (ECT) Trng hp khng cp cu nm ngoi cc tha thun trng hp n l trong mng li Mt s dch v chm sc sc khe th cht

Nh cung cp hoc nhm lm sng ca qu v phi yu cu Nhm xt duyt trc ca Mercy Maricopa chp thun cho cc dch v ny. Nu dch v c bao tr theo Title 19/21 bao gm trong k hoch nhn dch v ca qu v b t chi, ct gim hoc chm dt, qu v s nhn c thng bo v c quyn np n khng co. Quy trnh np n khng co c m t trong phn Khng co l g v lm cch no np n khng co? trn trang 45.

Ch bc s c o to iu tr tnh trng ca qu v mi c th t chi dch v m nh cung cp dch v hoc nhm lm sng ca qu v ang c gng xin chp thun.

Khng phi mi dch v u c sn cho tt c hi vin. Nh cung cp ca qu v cn gi yu cu xin chp thun. Nu h khng chc chn v cch thc hin iu , h c th gi cho B phn quan h vi nh cung cp ca chng ti min ph theo s 1-866-796-5598 c h tr. Nu qu v mun xem cc hng dn c s dng xc nh tnh trng nhp vin, tip tc nm vin v xut vin, hy lin h vi Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Nu dch v c bao tr theo Title 19/21 bao gm trong K hoch nhn dch v ca qu v b t chi, ct gim hoc chm dt, qu v s nhn c thng bo v c quyn np n khng co. Quy trnh np n khng co c m t trong phn Khng co cho hi vin iu kin tham gia AHCCCS theo Title 19/21.

Nhng ngi iu kin theo Title 19/21 Qu v s nhn c thng bo bng vn bn cho qu v bit nu cc dch v c nh cung cp hoc nhm lm sng ca qu v yu cu khng c chp thun. Qu v s nhn c thng bo ny trong vng 14 ngy k t ngy nh cung cp hoc nhm lm sng ca qu v yu cu c chp thun i vi cc yu cu chp thun tiu chun hoc trong vng 3 ngy lm vic i vi cc yu cu chp thun cn c gii quyt nhanh. Cn c gii quyt nhanh c ngha l mt quyt nh cn c a ra sm hn do cc nhu cu chm sc sc khe hnh vi ca qu v.

Khung thi gian m T/RBHA hoc nh cung cp phi gi thng bo bng vn bn cho qu v v quyt nh ca h i vi cc dch v c yu cu c th c gia hn thm ti a 14 ngy. iu ny c ngha l c th mt n 28 ngy a ra quyt nh v quy trnh chp thun tiu chun v ln n 17 ngy tr ln i vi quy trnh gii quyt nhanh. Qu v, Mercy Maricopa hoc nh cung cp dch v c th yu cu thm thi gian. Nu Mercy Maricopa hoc nh cung cp yu cu thm thi gian, qu v s nhn c mt thng bo bng vn bn c tn Thng bo gia hn khung thi gian ra quyt nh i vi vic cho php cung cp dch v, cho qu v bit l do ti sao s mt nhiu thi gian hn.

Nu qu v khng ng vi vic gia hn ny, qu v c th np n khiu ni vi Mercy Maricopa bng cch gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711. Nu quyt nh v cc dch v c yu cu ca qu v khng c a ra trong khung thi gian ti a c php, bao gm thi gian gia hn th yu cu chp thun (cho php) s c coi l b t chi vo ngy khung thi gian ht hn.

Nu cc dch v chm sc sc khe hnh vi c bao tr ca qu v b t chi, hoc cc dch v m qu v vn ang nhn c b chm dt, tm dng hoc ct gim, qu v s nhn c Thng bo hnh ng. Thng bo hnh ng l ti liu bng vn bn s cho qu v bit:


(Cc) dch v no s b t chi, ct gim, tm dng hoc kt thc L do gii thch ti sao (cc) dch v s b t chi, ct gim, tm dng hoc chm dt v c s

php l cho hnh ng Ngy m (cc) dch v s b ct gim, tm dng hoc chm dt Quyn np n khng co ca qu v Cch thc thc hin quyn np n khng co ca qu v Thi im v cch thc qu v c th yu cu quyt nh nhanh nu qu v np n khng co Cch thc yu cu tip tc cc dch v ca qu v trong qu trnh khng co

Qu v s nhn c Thng bo hnh ng 10 ngy trc ngy hiu lc nu cc dch v qu v ang nhn c s b ct gim, tm dng hoc chm dt.

Nu Thng bo hnh ng khng cho qu v bit l qu v yu cu iu g, iu g c quyt nh v l do ti sao c quyt nh bng ngn ng m qu v c th hiu c, vui lng gi cho Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 c h tr.

Nu Thng bo hnh ng khng y th mt Thng bo hnh ng mi s c cp. Nu Thng bo hnh ng vn khng cung cp cho qu v thng tin v vn vn cha c Mercy Maricopa gii quyt, qu v c th gi cho ADHS/DBHS theo s 602-364-4574 np n khiu ni. Thng bo hnh ng cng sn c bng cc ngn ng v nh dng khc nu qu v cn.

Cc trng hp ngoi l i vi yu cu Thng bo hnh ng trc 10 ngy Nu nghi ng c hnh vi gian ln, thng bo s c gi n cho qu v 5 ngy trc khi ct gim, tm dng

hoc chm dt dch v. Nu cc dch v ni tr khng cp cu b chm dt do kt qu ca vic t chi yu cu tip tc nm vin,

qu v s nhn c mt Thng bo hnh ng trong vng 2 ngy.

Qu v cng c th nhn c Thng bo hnh ng trong vong cha n 10 ngy k t ngy hiu lc nu: Qu v thng bo bng vn bn cho nh cung cp dch v ca qu v bit rng qu v khng cn mun

nhn dch v na Th ca qu v c gi tr li v nh cung cp dch v khng bit qu v u Qu v vo mt c s m khin qu v khng iu kin nhn dch v Qu v chuyn i v nhn cc dch v Medicaid bn ngoi Arizona Bc s ca qu v ch nh vic thay i mc chm sc sc khe hnh vi ca qu v

Nhng ngi c xc nh l mc bnh tm thn nghim trng L mt ngi c xc nh mc bnh tm thn nghim trng, qu v c th nhn c cc thng bo khc ngoi thng bo hnh ng. C th bao gm Thng bo v quyt nh v Quyn khng co. Qu v s nhn c thng bo ny khi: Xc nh ban u v bnh tm thn nghim trng c a ra Quyt nh v cc chi ph hoc min tr chi ph c a ra nh gi, K hoch dch v hoc iu tr ni tr v K hoch xut vin c xy dng hoc xem xt K hoch dch v ca qu v b thay i v bt k dch v no qu v ang nhn c b ct gim,

tm dng hoc chm dt Qu v c xc nh rng khng b mc bnh tm thn nghim trng

Da trn cc dch v chm sc sc khe hnh vi m qu v nhn c, qu v c th nhn c cc thng bo khc v quy trnh Than phin v Khng co, cc quyn hp php ca qu v v chng trnh khng c php phn bit i x vi qu v.

Vui lng lin h vi Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 nu c thc mc v vic chp thun dch v v quyn nhn thng bo ca qu v.


Thc hnh tt nht trong dch v chm sc sc khe hnh vi C ADHS/DBHS v RBHA u to ra v ng h cc thc hnh tt nht trong dch v chm sc sc khe hnh vi. Cc thc hnh tt nht l nhng cch cung cp dch v cho qu v c chng minh l hu ch, da trn nghin cu v nh gi cc thc hnh . Qu v c th tm hiu thm v cc thc hnh tt nht ny bng cch truy cp vo trang web ca ADHS/DBHS v RBHA. ADHS/DBHS c cc lin kt n Hng dn thc hnh lm sng v cng thc hnh lm sng trc tuyn ti www.azdhs.gov/bhs/guidance/index.htm. Trang web ca Mercy Maricopa cng c cc hng dn lm sng trong iu tr cho tr em v ngi ln: www.MercyMaricopa.org/providers/resources/guidelines.

Nu qu v mun nhn thng tin ny qua th, vui lng lin h vi Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711. Cc thc hnh tt nht thay i theo thi gian. Vuilng tham kho ADHS/DBHS v cc trang web Mercy Maricopa ca qu v bit cc cp nht hoc lin h vi Mercy Maricopa bit thm thng tin.

Cc dch v chm sc sc khe hnh vi c bao tr

S tay ny v bng trn trang 21-22 m t cc dch v m qu v c th nhn c. Qu v s nhn c thng bo nu c thay i i vi nhng dch v m qu v c th nhn c.

Cc dch v iu tr khng hong v cp cu i vi cc trng hp e da n tnh mng, lun gi 911.

i vi cc trng hp sc khe hnh vi khng e da n tnh mng, hy gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Vn chuyn cho trng hp cp cu v sc khe hnh vi c th c cung cp bng cch lin h vi Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Th ID Mercy Maricopa ca qu v c s in thoi lin h vi dch v chm sc sc khe hnh vi v lm dng dc cht. Cc dch v c ch nh cho nh cung cp ni qu v sinh sng. Nu qu v c thc mc hoc cn tr gip v vic nhn cc dch v chm sc sc khe hnh vi, vui lng gi n s trn th ca qu v.

Qu v c th cn cc dch v chm sc sc khe th cht hoc hnh vi khi qu v vng nh v ngoi khu vc dch v ca Mercy Maricopa. y c gi l dch v chm sc ngoi khu vc. Dch v chm sc ngoi khu vc ch bao gm cc dch v cp cu v sc khe hnh vi tr khi Mercy Maricopa ph duyt cc dch v khc. Qu v c quyn s dng bt k bnh vin hoc c s no khc cho chm sc cp cu. Nu qu v mun nhn dch v chm sc sc khe hnh vi khng cp cu ngoi khu vc dch v ca Mercy Maricopa, vui lng gi cho ban Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Nu qu v cn dch v chm sc ngoi khu vc: Hy n bnh vin hoc trung tm h tr khng hong v yu cu tr gip Yu cu bnh vin hoc trung tm h tr khng hong gi cho ban Dch v hi vin ca Mercy Maricopa

theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 Bnh vin hoc trung tm h tr khng hong s lin h vi Mercy Maricopa c ph duyt tip tc

cung cp cc dch v chm sc sc khe hnh vi.

Nu qu v gp phi tnh trng y t cp cu, cc dch v cp cu sn c cho qu v. Cc dch v cp cu khng cn c ph duyt.

Cc dch v chm sc sc khe hnh vi sn c Cc dch v chm sc sc khe hnh vi gip mi ngi c suy ngh, cm xc v hnh ng theo cch lnh mnh. C cc dch v dnh cho nhng vn v sc khe tm thn v c cc dch v dnh cho vn v lm dng dc cht.

http://www.azdhs.gov/bhs/guidance/index.htmwww.MercyMaricopa.org/providers/resources/guidelines


Qu v c th nhn c cc dch v da trn ba iu: Nhu cu ca qu v Khon bao tr bo him ca qu v S chp thun t nh cung cp dch v ca qu v, nu cn

Qu v quyt nh cng vi nh cung cp dch v hoc nhm lm sng1 ca qu v v vic qu v cn nhng dch v no. Nh cung cp dch v hoc nhm lm sng ca qu v c th yu cu Mercy Maricopa chp thun mt dch v cho qu v, nhng s chp thun ny c th b t chi. Nu yu cu dch v b t chi, qu v c th np n khng co. bit thm thng tin v vic np n khng co, xem phn tho lun v khng co.

Qu v v nh cung cp dch v ca qu v c th khng ng thun v cc dch v m qu v cn. Nu qu v cho rng qu v cn mt dch v v nh cung cp dch v ca qu v khng ngh nh th, hy lin h vi ban Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Bng di y lit k cc dch v chm sc sc khe hnh vi sn c v bt k hn ch no m cc dch v ny c th c. Mercy Maricopa ch phi chi tr cho cc dch v chm sc sc khe hnh vi sn c c lit k.

1Nhm lm sng bao gm Nhm tr em v gia nh v Nhm phc hi dnh cho ngi ln

21

Cc dch v chm sc sc khe hnh vi sn c*

DCH V TR EM V NGI LN THEO TITLE 19/21

NHNG NGI C XC NH MC SMI

KHNG THEO TITLE 19/21

CC DCH V IU TR

T vn v tr liu sc khe hnh vi

C nhn Sn c c cung cp da trn kinh ph ti tr sn c **

Nhm Sn c c cung cp da trn kinh ph ti tr sn c **

Gia nh Sn c c cung cp da trn kinh ph ti tr sn c **

Khm sng lc sc khe hnh vi, nh gi sc khe tm thn v xt nghim chuyn khoa

Khm sng lc sc khe hnh vi

Sn c c cung cp da trn kinh ph ti tr sn c **

nh gi sc khe tm thn

Sn c Sn c

Xt nghim chuyn khoa Sn c c cung cp da trn kinh ph ti tr sn c **

Chuyn mn khc Cha bnh truyn thng c cung cp da trn kinh ph ti tr sn c **

c cung cp da trn kinh ph ti tr sn c **

Nh chm c cung cp da trn kinh ph ti tr sn c **


CC DCH V PHC HI CHC NNG

o to v pht trin k nng

C nhn Sn c Sn c

Nhm Sn c Sn c

M rng Sn c Sn c

Phc hi chc nng nhn thc Sn c Sn c

Gio dc thc y/phng nga sc khe hnh vi Sn c Sn c

Cc dch v gio dc tm l v h tr lin tc duy tr vic lm

Dch v gio dc tm l Sn c Sn c

H tr lin tc duy tr vic lm

Sn c Sn c

CC DCH V Y T

Dch v thuc *** Sn c Sn c

Xt nghim, chp X-quang v chp hnh y t

Sn c Sn c

Qun l y t Sn c Sn c

Liu php sc in Sn c c cung cp da trn kinh ph ti tr sn c**


22

Cc dch v chm sc sc khe hnh vi sn c*

DCH V TR EM V NGI LN THEO TITLE 19/21

NHNG NGI C XC NH MC SMI

KHNG THEO TITLE 19/21

CC DCH V H TR

Qun l trng hp Sn c Sn c

Chm sc c nhn Sn c Sn c

o to chm sc ti nh (gia nh) Sn c Sn c

Dch v t lc/tng tr Sn c Sn c

o to chm sc ti nh cho khch hng chm sc ti nh (HCTC)

Sn c c cung cp da trn kinh ph ti tr sn c **

Dch v chm sc tm th Sn c Sn c

H tr nh c cung cp da trn kinh ph ti tr sn c**

c cung cp da trn kinh ph ti tr sn c**

Ngn ng k hiu hoc dch v thng dch c cung cp min ph cho hi vin

c cung cp min ph cho hi vin

Dch v ti tr linh hot c cung cp da trn kinh ph ti tr sn c**

c cung cp da trn kinh ph ti tr sn c**

Vn chuyn Trng hp cp cu Sn c Gii hn vn chuyn lin quan n dch v iu tr khng hong

Trng hp khng cp cu Sn c Sn c

DCH V CAN THIP KHUNG HOANG

Can thip khng hong in thoi di ng Sn c Sn c

Can thip khng hong in thoi c nh Sn c Sn c

Cc dch v iu tr khng khong n nh Sn c Sn c

DCH V NI TR

Bnh vin Sn c Sn c nhng c hn

C s chm sc sc khe hnh vi ni tr Sn c Sn c nhng c hn

DCH V C TR

C s chm sc sc khe hnh vi ngoi tr Sn c Sn c nhng c hn

Chi ph n c cung cp da trn kinh ph ti tr sn c **


CC CHNG TRINH CHM SC SC KHOE HNH VI BAN NGY

Ngy c gim st Sn c Sn c

Ngy tr liu Sn c c cung cp da trn kinh ph ti tr sn c **

Ngy y t Sn c c cung cp da trn kinh ph ti tr sn c **



Gii hn:

* bit cc dch v hin sn c thng qua cc khon tr cp trn gi ca lin bang, vui lng xem mc thnh phn dn s c bit trang 31.

** Cc dch v khng sn c bng kinh ph T19/21, nhng c th c cung cp da trn kinh ph ti tr sn c v vic s dng qu chung c chp thun.

*** Hy xem Cng thc ca Mercy Maricopa bit thm thng tin v thuc c bao tr.

Chm sc tm th - Dch v chm sc tm th c cung cp nh thi gian tm ngh nhng ngi chm sc dnh thi gian cho bn thn h. Nhu cu ca hi vin l c s xc nh s gi chm sc tm th c s dng. S gi chm sc tm th sn c l 600 gi trong khong thi gian 12 thng. Khong thi gian 12 thng s bt u t ngy 1 thng 10 n ht ngy 30 thng 9 ca nm tip theo.

Mt ngi c th c ch nh ngi qun l trng hp, da trn nhu cu ca ngi .

Khon bao tr c gii hn cc dch v ko di ti a 23 ting lin quan n vic theo di/n nh khng hong, bao gm cc dch v cai nghin. Ln n 72 ting dnh cho dch v n nh khng hong b sung c th c bao tr da trn tnh sn c ca kinh ph.

24

M t quyn li/dch v chm sc sc khe hnh vi

bit thm thng tin, hy xem hng dn v dch v c bao tr ca Mercy Maricopa trc tuyn: www.MercyMaricopa.org/members/mmic/benefits

DCH V/QUYN LI M TA KHC CC DCH V IU TR T vn v tr liu sc khe hnh vi

Tr liu tng tc c thit k khai thc thng tin, xc nh cc vn hoc mu thun v hnh vi v cung cp h tr v gio dc s dng trong tng lai.

C th cung cp cho c nhn, nhm ngi, mt gia nh hoc nhiu gia nh

Khm sng lc sc khe hnh vi, nh gi sc khe tm thn v xt nghim chuyn khoa

Thu thp v nh gi thng tin hin ti v trc y, trao i trc tip vi hi vin, gia nh hoc nhm ngi bng tm tt vn bn hoc bo co.

Chuyn mn khc Cc dch v iu tr khc c cung cp bi nhng ngi iu kin gim triu chng v ci thin hoc duy tr hot ng.

Bao gm nhng khng gii hn i vi: Cc dch v chm sc sc khe tm thn m khng cn tip xc trc tip, phn hi sinh hc

CC DCH V PHC HI CHC NNG o to v pht trin k nng Hng dn cc k nng giao

tip, x hi v sng t lp cho c nhn v/hoc gia nh ca h nhm gip h sng t lp hn v ha nhp vi cng ng.

Bao gm nhng khng gii hn i vi: T chm sc bn thn, quan tm n ni n , qun l tin v s dng cc ti nguyn khc

Phc hi chc nng nhn thc

H tr phc hi t cc vn v nhn thc (tm thn) t lp hn v hot ng mc cao nht c th.

Bao gm nhng khng gii hn i vi: Hc li mt s kh nng tr tu nht nh, hot ng mnh hn, b sung cc k nng mi thay th cho k nng mt

Gio dc thc y/phng nga sc khe hnh vi

Gio dc v o to mt c nhn hoc nhm lin quan n k hoch iu tr ca mt ngi.

Bao gm nhng khng gii hn i vi: Nng cao kin thc v ch lin quan n sc khe, s dng thuc em li kt qu tt nht, qun l stress, k nng lm cha m

Cc dch v gio dc tm l v h tr lin tc duy tr vic lm

c thit k h tr mt ngi hoc mt nhm chn, tm kim v gi cng vic hoc hot ng cng ng c ngha khc.

c iu chnh h tr nhng ngi nhiu c s khc nhau chng hn nh lm vic bn thi gian, kinh nghim lm vic khng c thanh ton hoc cng vic tnh nguyn c nha ph hp vi tui, kh nng v thc trng ca ngi .


www.MercyMaricopa.org/members/mmic/benefits

25

DCH V/QUYN LI M TA KHC CC DCH V Y T Dch v thuc Thuc c k toa bi bc s,

chuyn vin iu dng hoc tr l bc s c cp php nhm phng nga, n nh hoc ci thin cc triu chng l mt phn ca iu kin chm sc sc khe hnh vi hoc iu tr.

Hy xem Danh mc thuc ca Mercy Maricopa ti www.MercyMaricopa.org/members/ mmic/pharmacy

Xt nghim, chp X-quang v chp hnh y t

Xt nghim chn on, sng lc hoc theo di iu kin sc khe hnh vi.

iu ny c th bao gm nhng khng gii hn i vi xt nghim mu v nc tiu, chp CT, MRI, EKG v EEG

Qun l y t Cc dch v qun l v nh gi c cung cp bi chuyn gia y t c cp php (v d: bc s, chuyn vin iu dng, tr l bc s hoc y t) cho c nhn nh l mt phn ca qu trnh thm khm cho mc ch iu tr tip theo.

Bao gm s dng thuc em li kt qu tt nht s bao gm vic tm hiu v tc dng cng nh tc dng ph ca thuc v thuc mi c th khin qu v cm thy th no khi s dng ln u tin.

Liu php sc in Mt phng php iu tr m dng in ngn c truyn qua no ca mt ngi, thng c s dng cho trng hp trm cm nghim trng.

Cc dch v phi c cung cp bi bc s c cp php vi s h tr gy m trong bnh vin.

CC DCH V H TR Qun l trng hp Dch v h tr c cung cp

tng tnh hiu qu v mc tiu iu tr.

Bao gm nhng khng gii hn i vi: H tr trong vic s dng v tip tc s

dng cc dch v c bao tr Lin h qua in thoi hoc trc tip vi

mt ngi hoc gia nh gip ci thin v gip ngi hot ng tt

H tr trong vic tm kim tr gip p ng cc nhu cu c bn

Giao tip v iu phi dch v chm sc vi gia nh ca ngi , nh cung cp dch v chm sc, cng ng v cc c quan khc ca Tiu bang

Chm sc c nhn Cc hot ng h tr nhm tr gip mt ngi thc hin cng vic hng ngy v cc hot ng khc cn thit sng trong cng ng.

Bao gm nhng khng gii hn i vi: h tr cng vic ni tr, chm sc c nhn, dng thuc ng cch.


26

DCH V/QUYN LI M TA KHC o to chm sc ti nh (gia nh)

Cc dch v dnh cho gia nh - o to chm sc ti nh (h tr gia nh) cn gp trc tip (cc) thnh vin trong gia nh nhm ti thit, ci thin hoc gip gia nh thc hin, mt ngi c th sng trong gia nh v cng ng.

C th bao gm cc hot ng h tr chng hn nh h tr gia nh sa khuyt tt ca ngi, xy dng k nng gip hng dn ngi , hiu nguyn nhn v cch iu tr cho vn sc khe hnh vi, hiu v c th s dng cc dch v ca h thng.

Dch v t lc/tng tr Tr gip s dng dch v chng hn nh xy dng k hoch chm sc, xc nh nhu cu, tm kim ngun h tr, lm vic vi cc chuyn gia, vt qua cc ro cn hoc hiu v ng u vi stress l mt phn ca khuyt tt ca ngi (v d: cc nhm h tr), hun luyn, m hnh ha vai tr v t vn.

i vi cc hi vin v/hoc gia nh ca h, nhng ngi cn nhiu cu trc v dch v hn so vi nhng ngi qu v c th gp trong cc nhm i hu phc hi da vo cng ng.

o to chm sc ti nh cho khch hng chm sc ti nh (HCTC)

Nhng dch v do nhn vin ca trung tm iu tr sc khe hnh vi cung cp cho ngi sng trong gia nh gip v h tr ngi ny t c mc tiu k hoch dch v ca h. Dch v ny cng gip nhng ngi sng c s cng ng v khng c hng dch v chm sc ti ni c tr.

Bao gm nhng khng gii hn i vi cc dch v h tr chm sc sc khe hnh vi chng hn nh chm sc c nhn. Cuc sng cng ng, o to k nng, vn chuyn n cuc hn iu tr hoc tr liu ln lch.

Dch v chm sc tm th Cc dch v chm sc sc khe hnh vi ngn hn hoc gim st tng th cung cp thi gian ngh ngi hoc th gin cho thnh vin gia nh hoc c nhn khc chm sc cho hi vin c hng dch v chm sc sc khe hnh vi.

Cc dch v c th c cung cp trn c s ngn hn (ngha l mt vi gi trong ngy) hoc trong thi gian di hn bao gm lu tr qua m.

H tr nh H tr nhn v c trong c s cng ng c lp bao gm nh ring hoc chung c ca ngi v nh thuc s hu hoc thu bi nh cung cp k hp ng ph.

C th bao gm tr gip v vic thanh ton tin thu nh v dch v tin ch v tr gip v vic chuyn nh cc hi vin v gia nh ca h c th tm v c nh.


27

DCH V/QUYN LI M TA KHC Ngn ng k hiu hoc dch v thng dch

Dch v c sn min ph i vi cc hi vin; dch v cho tt c ngn ng khng phi ting Anh v ngi khim thnh hoc nng tai phi c sn cho cc hi vin tim nng, min ph, khi yu cu thng tin.

Ngn ng k hiu hoc dch v thng dch c cung cp cho nhng c nhn v/hoc gia nh ca h vi kh nng ngn ng gii hn hoc cc ro cn giao tip khc (v d: k hiu hoc m thanh) trong khi hng dn v cch truy cp dch v, t vn v cc hot ng iu tr s gip h nhn c cc dch v chm sc sc khe tm thn m h cn.

Dch v ti tr linh hot T/RBHA c th tip cn qu ti chnh linh hot mua bt k hng ha v/hoc dch v dng mt ln hoc khng thng xuyn cn thit cho hi vin (tr em hoc ngi ln) v gia nh ca h, khi khng th mua hng ha v/hoc dch v bng bt k ngun vn no khc v hng ha hoc dch v c lin quan trc tip n chng trnh dch v ca hi vin.

Qu ny nhm tng cng sc khe, s thoi mi v an ton cho tr em v ngi ln d b tn thng tr li vi cng ng theo cch ring, ng tn trng.

H tr v/hoc dch v khng cn thit v mt y t

Vn chuyn H tr hi vin trong vic i t ni ny n ni khc gip h nhn cc dch v v t c mc tiu chng trnh dch v.

iu ny bao gm c vn chuyn trong trng hp cp cu v trng hp khng cp cu.

Vn chuyn trong trng hp cp cu khng cn c chp thun trc.

Vn chuyn trong trng hp khng cp cu phi c cung cp cho cc c nhn v/hoc gia nh khng th thu xp hoc chi tr cho vic i li ca mnh hoc nhng ngi khng tip cn c dch v vn chuyn min ph n dch v chm sc sc khe hnh vi c bao tr cn thit v mt y t.

DCH V CAN THIP KHUNG HOANG Can thip khng hong tn ni

Cc dch v c cung cp bi nhm di ng hoc ngi i n ni m mt ngi ang gp khng hong (v d: ni c tr ca ngi , phng cp cu, tri giam, c s cng ng).

Bao gm cc dch v nhm nh gi v n nh ngay lp tc cc triu chng cp tnh ca bnh tm thn, ru v nghin ma ty khc v cng thng v cm xc. Dch v ny nhm: n nh cc triu chng hnh vi hoc iu

tr cp tnh nh gi cc nhu cu iu tr Pht trin cc chng trnh nhm p ng

nhu cu ca nhng ngi c phc v


28

DCH V/QUYN LI M TA KHC Can thip khng hong in thoi

Dch v nhm cung cp vic iu tr, gii thiu v h tr qua in thoi cho nhng ngi ang gp khng hong; thng cung cp ni u tin tip cn h thng chm sc sc khe hnh vi.

Dch v ny cng c th bao gm cuc gi in tip theo m bo ngi n nh.

Can thip khng hong-n nh

Dch v chm sc sc khe hnh vi trc tip v khng theo lch trnh c cung cp: (a) Nhm gii quyt vn v chm sc sc khe hnh vi ca mt c nhn ngn nga tn hi, n nh v gii quyt vn sc khe hnh vi cp tnh v (b) c s ni tr hoc trung tm iu tr ngoi tr

Cc dch v can thip khng hong (n nh) phi c cung cp bi cc c s c giy php DLS. Nhng ngi cung cp cc dch v ny phi l chuyn gia v chm sc sc khe hnh vi, k thut vin chm sc sc khe hnh vi hoc ph t ca chuyn gia v chm sc sc khe hnh vi.

DCH V NI TR Bnh vin Dch v ni tr (bao gm

phng v tin n) Cung cp iu tr lin quan bao gm dch v chm sc tm thn tng qut, cai nghin v/ hoc dch v php l bnh vin a khoa hoc bnh vin a khoa c b phn ring hoc c s tm thn c lp. Cng bao gm dch v gim st chm sc bnh nhn 24 gi v bc s ti ch v theo yu cu.

C s chm sc sc khe hnh vi ni tr

iu tr tm thn ni tr, bao gm chng trnh kt hp iu tr ti ni c tr, cc hot ng v kinh nghim c cung cp cho ngi di 21 tui v c triu chng sc khe hnh vi cp tnh hoc nghim trng. C hai loi hnh trung tm iu tr ti ni c tr:

An ton - trung tm iu tr ti ni c tr thng thu nhn vin bo v v s dng thit b gim st v bo ng.

Khng an ton trung tm iu tr ti ni c tr khng c kha.

iu tr lin tc cho ngi ang c cc triu chng lm dng dc cht v/hoc sc khe hnh vi cp tnh v nghim trng. Cc dch v c th bao gm nh gi v tip nhn khn cp; can thip v n nh khng hong; t vn c nhn, nhm v gia nh; cai nghin v gii thiu. Cng bao gm dch v gim st chm sc bnh nhn 24 gi v bc s ti ch hoc theo yu cu.


29

DCH V/QUYN LI M TA KHC DCH V C TR C s chm sc sc khe hnh vi ngoi tr

Dch v c tr c cung cp bi c quan qun l sc khe hnh vi c cp php. Nhng c quan ny cung cp c s iu tr c c cu vi dch v gim st chm sc v t vn 24 gi hoc cc hot ng iu tr khc cho nhng ngi khng yu cu dch v y t ti ch di s gim st ca chuyn gia v chm sc sc khe hnh vi ti ch hoc theo yu cu.

Chi ph n khng c bao tr theo Title 19/21 cho nhng ngi ang c tr trong cc c s chm sc sc khe hnh vi ti ni c tr.

Chi ph n Vic cung cp n cho ngi c tr trong c s ti ni c tr hoc c s c lp c h tr.

Bao gm nhng khng gii hn i vi cc dch v chng hn nh n v chun b n, git gi c nhn v dn dp nh ca.

CC CHNG TRINH CHM SC SC KHOE HNH VI BAN NGY Ngy c gim st Chng trnh c ln lch

thng xuyn ca cc hot ng/dch v dnh cho c nhn, nhm v/hoc gia nh lin quan n k hoch iu tr ca ngi ghi danh c thit k ci thin kh nng hot ng ca mt ngi cng ng.

C th bao gm cc dch v h tr v phc hi sau y: o to v pht trin k nng, phng/ tng cng sc khe hnh vi, o to v h tr v thuc, h tr lin tc duy tr vic lm v cc dch v t lc/tng tr.

Ngy tr liu Chng trnh c ln lch thng xuyn ca cc c s iu tr hin hot.

Bao gm nhng khng gii hn i vi cc dch v chng hn nh t vn v iu tr sc khe hnh vi dnh cho c nhn, nhm v/hoc gia nh, o to v pht trin k nng, phng/ tng cng sc khe hnh vi, o to v h tr v thuc, h tr lin tc duy tr vic lm, cc dch v dnh cho gia nh - o to chm sc ti nh (h tr gia nh), gim st thuc, qun l trng hp v cc dch v t lc/tng tr.

Ngy y t Chng trnh c ln lch thng xuyn ca cc c s iu tr hin hot, bao gm can thip y t, mt c s nhm.

C th bao gm t vn v iu tr sc khe hnh vi dnh cho c nhn, nhm v/hoc gia nh, o to v pht trin k nng, phng/ tng cng sc khe hnh vi, o to v h tr v thuc, h tr lin tc duy tr vic lm, cc dch v dnh cho gia nh - o to chm sc ti nh (h tr gia nh) v/hoc cc dch v iu dng khc nh gim st thuc, qun l methadone v nh gi y t/iu dng.



Khon bao tr thuc (cc dch v nh thuc) Mercy Maricopa c danh sch cc loi thuc c gi l danh mc thuc bao gm cc loi thuc c cung cp cho qu v thng qua Mercy Maricopa. Qu v c th tm thy danh mc thuc ca Mercy Maricopa trc tuyn ti www.MercyMaricopa.org/members/mmic/pharmacy. Qu v c th cn dng thuc khng c trong danh mc thuc ca Mercy Maricopa hoc qu v c th cn phi c chp thun cho thuc ca qu v. Nu thuc ca qu v khng c trn danh sch thuc c chp thun, bc s k n ca qu v c th: K thuc tng t c trn danh sch Yu cu Mercy Maricopa a ra trng hp ngoi l v bao tr thuc cn thit v mt y t. Nh cung cp dch

v ca qu v s c quy trnh cho php trc.

Nu thuc b t chi, ct gim hoc chm dt, qu v v nh cung cp dch v ca qu v s nhn c thng bo trong th v c quyn np n khng co. Th ny s gii thch quy trnh np n khng co, cng vi mi quyn v quy tc b sung c p dng. Quy trnh ny cng c m t trong phn c tn Khng co ca hi vin trn trang 45.

Nu qu v i ti mt nh thuc c trong mng li ca Mercy Maricopa mua toa thuc nhng b t chi bi Nh thuc , vui lng gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Nu qu v cn dch v nh thuc sau gi hnh chnh, vo cui tun hoc k ngh, c nhiu nh thuc m ca 24 gi, 7 ngy mt tun. Qu v c th tm thy danh sch cc nh thuc trn trang web ca Mercy Maricopa ti www.MercyMaricopa.org/findpharmacy. Qu v c th gi cho Dch v hi vin ca Mercy Maricopa nu cn tr gip v vic tm mt nh thuc m ca gn qu v.

Vn chuyn n cuc hn chm sc sc khe hnh vi (a n) Qu v c th c a n v n v t cc dch v khng phi cp cu i vi dch v chm sc sc khe hnh vi, chng hn nh cuc hn y t. Hy lin h vi ngi qun l trng hp ca qu v hoc Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465, (TTY/TDD) 711 v hi xem liu qu v c c a n hay khng.

Dch v vn chuyn trong trng hp cp cu khng cn c chp thun trc. Hy gi 911 hoc lin h vi Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 c vn chuyn trong trng hp cp cu hoc khng hong.

Xt nghim HIV/AIDS Ph n c thai tham gia AHCCCS nn trao i vi PCP hoc OB-GYN v xt nghim Virus lm suy gim min dch ngi/Hi chng suy gim min dch mc phi (HIV/AIDS). Nhng ph n nhn c kt qu xt nghim dng tnh cng nn hi v dch v t vn.

Cc dch v xt nghim HIV/AIDS mang tnh t nguyn, b mt c cung cp sn, cng nh t vn cho cc hi vin c kt qu xt nghim dng tnh. Mercy Maricopa c th gip nu qu v cn gip . Hy gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 bit thng tin v dch v t vn v xt nghim b mt.

Khon bao tr dch v dnh cho cc nhm c bit

Khon bao tr dch v dnh cho ngi M Da Ngi M Da c la chn v a im tip cn vi cc dch v chm sc sc khe hnh vi, bao gm tip nhn cc dch v thng qua RBHA phc v cho khu vc m zip ni qu v sng hoc TRBHA phc v mt b lc c th, Dch v y t dnh cho Ngi Da (Indian Health Services (IHS)) v/hoc cc c s dnh cho b lc 638 c cc chng trnh chm sc sc khe hnh vi. Nu qu v nhn cc dch v thng qua RBHA hoc TRBHA, th nhng dch v s c chi tr thng qua S dch v y t Arizona/Ban dch v chm sc sc khe hnh vi (Arizona Department of Health Services/Division of Behavioral Health services (ADHS/DBHS)). Nu qu v iu

www.MercyMaricopa.org/find-pharmacywww.MercyMaricopa.org/members/mmic/pharmacy


kin theo Tiu 19/21 v nhn cc dch v thng qua IHS hoc c s dnh cho b lc 638, AHCCCS s chi tr cho nhng dch v . Bt k l ai chi tr cho cc dch v, RBHA hoc TRBHA ca qu v v/hoc IHS hoc c s dnh cho b lc 638 s iu phi dch v chm sc ca qu v m bo qu v nhn c tt c cc dch v chm sc sc khe hnh vi cn thit.

C s dnh cho b lc 638 c ngha l mt c s thuc s hu v c vn hnh bi mt b lc ngi M Da c y quyn cung cp cc dch v theo Cng Lut 93-638 sa i. C s dnh cho b lc 638 c th khng cung cp tt c cc dch v chm sc sc khe hnh vi c bao tr, v th ADHS/DBHS chu trch nhim bao tr mt s dch v: Cc dch v chm sc sc khe hnh vi dnh cho nhng ngi c gii thiu t IHS hoc c s dnh

cho b lc 638 Cc dch v cp cu c cung cp ti c s khng phi IHS hoc c s dnh cho b lc khng phi 638 cho

nhng ngi tip nhn dch v chm sc sc khe hnh vi l ngi M Da

Nu qu v khng chc chn v nhng la chn ca mnh, hoc nu qu v c thc mc v cch thc iu phi cc dch v chm sc sc khe hnh vi ca mnh, qu v c th lin h vi ban Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 bit thm thng tin.

Khon bao tr dch v dnh cho thnh phn dn s c bit Thnh phn dn s c bit gm cc nhm ngi c iu kin nhn cc dch v c ti tr bi cc khon tr cp trn gi ca lin bang. Nhng khon tr cp trn gi ca lin bang ny bao gm SABG, D n h tr chuyn tip t tnh trng v gia c (Project for Assistance in Transition from Homelessness (PATH)) v MHBG. Kinh ph t khon tr cp trn gi SABG c s dng cho cc dch v iu tr v h tr phc hi di hn cho nhng ngi sau y, theo th t u tin: Ph n mang thai/thanh thiu nin tim chch ma ty Ph n mang thai/thanh thiu nin lm dng dc cht Nhng i tng khc tim chch ma ty Nhng ph n v thanh thiu nin lm dng dc cht c tr ph thuc v gia nh, bao gm nhng ph

n c gng ginh li quyn nui con V ngun kinh ph l sn c tt c nhng ngi khc mc chng ri loi do lm dng dc cht, bt k gii

tnh hay l trnh s dng

PATH Grant cung cp kinh ph cho cc dch v dnh cho cc c nhn v gia nh: V gia c hoc sp c nguy c tr nn v gia c ang mc bnh tm thn nghim trng Mc chng ri lon do lm dng dc cht v c xc nh l mc bnh tm thn nghim trng

Cc n lc tip cn cng ng c m rng bao gm nhng thnh phn dn s sau y: Nn nhn ca bo lc gia nh Ngi gi Gia nh Thanh thiu nin b b ri v/hoc b nh ra i

PATH Grant cung cp cc dch v v h tr sau y: Tip cn v gio dc cng ng nh gi v thm nh ti ch H tr tip nhn/phn loi iu tr cp cu v khng cp cu H tr vn chuyn Phiu gim gi khch sn trong cc trng hp khn cp H tr p ng cc nhu cu c bn (v d nh np n ng k AHCCCS, SSI/SSDI, phiu thc phm, iu

phi dch v chm sc sc khe, v.v.) Qu trnh chuyn i sang h thng qun l trng hp v sc khe hnh vi


H tr mua cc thuc theo toa H tr xc nh cc trm lm mt hoc lm nng v cc trm cp nc trong thi gian c cnh bo v thi

tit cc nng v cc lnh H tr di chuyn Gii thiu nh , c cc sp t b tr chuyn tip v lu di

MHBG cp kinh ph dng thit lp hoc m rng cc dch v ti cng ng dnh cho cc dch v chm sc sc khe tm thn c th bi hon khng thuc Title 19/21 dnh cho nhng tr mc chng Ri lon cm xc nghim trng (SED) v nhng ngi ln mc SMI.

Khon bao tr dch v cho cc hi vin khng iu kin tham gia AHCCCS

Dch v iu tr khng hong Qu v c th nhn dch v iu tr khng hong, ngay c khi qu v khng iu kin theo Tiu 19/21 (ngha l khng iu kin tham gia AHCCCS) hoc c xc nh l mc bnh tm thn nghim trng. Cc dch v iu tr khng hong sn c cho qu v bao gm: Dch v can thip khng hong qua in thoi c nh, bao gm s in thoi min ph sn c 24 gi mt

ngy, 7 ngy mt tun bng cch gi ti ng dy tr gip khng hong v sc khe hnh vi ca Ht Maricopa theo s 602-222-9444 hoc 1-800-631-1314; (TTY/TDD) 1-800-327-9254

Dch v can thip khng hong qua in thoi di ng, sn c 24 gi mt ngy, 7 ngy mt tun Cc dch v theo di/n nh khng hong trong 23 ting, bao gm cc dch v cai nghin v khi ngun kinh

ph cho php, ln ti 72 ting dnh cho n nh khng hong b sung Dch v gii thiu v thng tin cng ng (cc nhm h tr, nh cung cp dch v chm sc sc khe hnh

vi c thang trt ph v thng tin v tnh iu kin nhn quyn li) Cc dch v iu tr khng hong lin quan n lm dng dc cht, bao gm cc dch v theo di n nh

Dch v cho nhng ngi c xc nh l mc SMI khng theo Tiu 19/21 Nu qu v l ngi c xc nh mc SMI khng theo Tiu 19/21, th qu v iu kin nhn mt lot cc dch v da trn ngun kinh ph sn c, theo quy nh ph hp ca C quan Lp php Arizona. Qu v c th thy danh sch nhng dch v ny trn trang 21.

Vui lng lin h vi Mercy Maricopa bng cch gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711 nu qu v c thc mc v nhng dch v no sn c cho qu v.

Dch v nh H tr nh l dch v dnh cho cc c nhn c xc nh l mc bnh tm thn nghim trng, gip h tm thy v c ti ni sinh sng an ton, c lp. Cc dch v H tr nh c th bao gm tr gip tin thu nh, thanh ton tin ga v tin in v tr gip trnh b trc xut. Nhng ngi iu kin theo Tiu 19/21 v khng theo Tiu 19/21 c xc nh l mc SMI ang nhn cc dch v nh ti cc c s c tr c th c yu cu gip thanh ton chi ph n .

Thnh phn dn s c bit Mt s ngi iu kin nhn cc dch v chm sc sc khe hnh vi c ti tr thng qua cc khon tr cp trn gi ca lin bang. bit thm thng tin v cc dch v ny v ai iu kin nhn cc dch v ny, vui lng chuyn n trang 31.


Chp thun iu tr, bo mt v ch th trc

Chp thun iu tr Qu v c quyn chp nhn hoc t chi dch v chm sc sc khe hnh vi c cung cp cho qu v. Nu qu v mun nhn cc dch v chm sc sc khe hnh vi c cung cp, qu v hoc ngi gim h hp php ca qu v phi k mu chp thun iu tr cung cp s cho php ca qu v hoc ngi gim h hp php ca qu v qu v nhn c cc dch v chm sc sc khe hnh vi. Khi qu v k mu "chp thun iu tr, qu v cng ang cho php S dch v y t Arizona/Ban dch v chm sc sc khe hnh vi (ADHS/DBHS) truy cp h s ca qu v.

cung cp cho qu v mt s dch v nht nh, nh cung cp dch v ca qu v cn c s cho php ca qu v. Nh cung cp dch v ca qu v c th yu cu qu v k vo mu hoc cho php bng li nhn c mt dch v c th. Qu v s c cung cp thng tin v dch v qu v c th quyt nh xem mnh c mun nhn dch v hay khng. iu ny c gi l chp thun vi hiu bit sng sut. Chp thun vi hiu bit sng sut c ngha l t vn cho bnh nhn v mt phng php iu tr, th thut gii phu, thuc hng thn hoc th tc chn on c xut; cc la chn thay th iu tr, th thut gii phu, thuc hng thn hoc th thut chn on ; cc ri ro i km v bin chng c th xy ra v vic nhn s cho php bng vn bn cho phng php iu tr, th thut gii phu, thuc hng thn hoc th tc chn on c xut t bnh nhn hoc i din ca bnh nhn. V d nh nu nh cung cp dch v ca qu v k toa mt loi thuc. Nh cung cp dch v ca qu v s cho qu v bit v cc li ch v ri ro khi dng loi thuc v cc phng n iu tr khc. Nh cung cp dch v ca qu v s yu cu qu v k mu chp thun hoc cho php bng li nu qu v mun dng loi thuc . Hy cho nh cung cp dch v ca qu v bit nu qu v c thc mc hoc khng hiu thng tin m nh cung cp dch v ca qu v cung cp cho qu v. Qu v c quyn rt li chp thun ca mnh bt k lc no. Nh cung cp dch v ca qu v s gii thch cho qu v iu g s xy ra nu qu v chn rt li chp thun ca mnh.

Thng tin sc khe hnh vi ca ti c mang tinh ring t khng? C cc lut quy nh v nhng ai c th xem thng tin sc khe hnh vi ca qu v khi c hoc khng c s cho php ca qu v. Thng tin v iu tr lm dng dc cht v bnh truyn nhim (v d nh thng tin v HIV/AIDS) khng c php chia s vi nhng ngi khc khi khng c s cho php ca qu v.

i khi, khng cn s cho php ca qu v chia s thng tin sc khe hnh vi ca qu v nhm gip b tr v thanh ton cho chm sc ca qu v. Cc trng hp ny c th bao gm chia s thng tin vi: Cc bc s v cc c quan khc cung cp dch v y t, x hi hoc phc li Nh cung cp dch v y t chm sc chnh ca qu v Mt s c quan ca tiu bang tham gia vo vic chm sc v iu tr ca qu v, khi cn Cc thnh vin nhm lm sng tham gia vo vic chm sc qu v

Trong nhng trng hp khc, c th hu ch khi chia s thng tin sc khe hnh vi ca qu v vi cc c quan khc, chng hn nh trng hc. C th cn s cho php bng vn bn ca qu v trc khi chia s thng tin ca qu v.

C th c nhng dp qu v mun chia s thng tin sc khe hnh vi ca qu v vi cc c quan khc hoc mt s c nhn c th ang h tr qu v. Trong nhng trng hp ny, qu v c th k tn vo Mu cho php tit l thng tin, trong nu rng cc h s y t ca qu v hoc mt s phn hn ch trong h s y t ca qu v, c th c tit l cho cc c nhn hoc c quan m qu v nu tn trong mu . bit thm thng tin v Mu cho php tit l thng tin, hy lin h vi Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.

Qu v c th yu cu xem thng tin sc khe hnh vi trong h s y t ca qu v. Qu v cng c th yu cu thay i h s nu qu v khng ng vi ni dung bn trong. Qu v cng c th nhn c mt bn sao h s y t ca qu v min ph mi nm. Hy lin h vi nh cung cp dch v ca qu v hoc Mercy Maricopa yu cu xem hoc nhn bn sao h s y t ca qu v. Qu v c th lin h vi Dch v hi vin theo s 6025861841 hoc 18005645465; (TTY/TDD) 711. Qu v s nhn c phn hi cho yu cu ca qu v trong vng 30 ngy. Nu qu v nhn c vn bn t chi yu cu ca qu v, qu v s c cung cp thng tin cho bit l do ti sao yu cu c c h s y t ca qu v b t chi v lm th no qu v c th c xem xt li s t chi .


Cc trng hp ngoi l v bo mt C nhng trng hp khi chng ti khng th gi bo mt thng tin. Cc thng tin sau y khng c php lut bo v: Nu qu v gy ti c hay e da s gy ti c vi chng trnh hoc i vi bt k ngi no lm vic ti

chng trnh, chng ti phi gi cnh st. Nu qu v nh lm tn thng ngi khc, chng ti phi cho ngi bit h c th bo v chnh

mnh. Chng ti cng phi gi cnh st. Chng ti phi bo co trng hp nghi ng lm dng tr em ln chnh quyn a phng. Nu c nguy c qu v c th lm tn thng bn thn, chng ti phi c gng bo v qu v. Nu iu ny

xy ra, chng ti c th cn phi ni chuyn vi nhng ngi khc trong cuc sng ca qu v hoc cc nh cung cp dch v khc (v d: cc bnh vin v cc c vn khc) bo v.

Ch th trc Qu v c quyn a ra ch th trc. Ch th trc cho bit nhng mong mun ca mt ngi v loi dch v chm sc m ngi mun hoc khng mun nhn khi ngi khng th a ra quyt nh do bnh trng ca mnh. Ch th trc v y t cho bc s bit nhng mong mun ca mt ngi nu ngi khng th ni ln c

nhng mong mun ca mnh do mt vn y t. Ch th trc v chm sc sc khe tm thn cho nh cung cp dch v chm sc sc khe hnh vi bit

nhng mong mun ca mt ngi nu ngi khng th nu ln nhng mong mun ca mnh do mc mt bnh tm thn.

Mt loi ch th trc v chm sc sc khe tm thn l Giy y quyn chm sc sc khe tm thn cung cp cho mt ngi ln quyn ch nh mt ngi ln khc a ra quyt nh v iu tr chm sc sc khe hnh vi thay mt mnh. Ngi c nu tn, ngi c ch nh, c th a ra quyt nh thay mt cho ngi ln nu ngi

khng th a ra nhng quyt nh kiu nh vy. Tuy nhin, ngi c ch nh khng c l nh cung cp dch v trc tip tham gia vo vic iu tr chm

sc sc khe hnh vi ca ngi ln ti thi im ch nh Giy y quyn chm sc sc khe tm thn. Ngi c ch nh c th hnh ng trong quyn hn ny cho n khi thm quyn ca mnh b thu hi bi

ngi ln hoc theo lnh ca ta n. Ging vi ngi ln , ngi c ch nh c quyn nhn thng tin v xem xt h s y t ca ngi ln

v vic iu tr chm sc sc khe hnh vi c th c v chp thun chia s thng tin v cc h s y t. Ngi c ch nh phi lm theo mong mun ca ngi ln nh nu trong Giy y quyn chm sc

sc khe tm thn. Tuy nhin, nu nhng mong mun ca ngi ln khng c nu trong Giy.

Trong mt vi trng hp c hn, mt s nh cung cp dch v c th khng thc hin theo ch th trc do vn v lng tm. Nu nh cung cp dch v chm sc sc khe hnh vi ca qu v khng thc hin theo cc ch th trc do vn v lng tm, nh cung cp dch v phi cung cp cho qu v cc chnh sch bng vn bn m: Nu r cc phn i v mt lng tm trn ton c s v nhng phn i ca c nhn cc bc s Xc nh lut cho php nhng phn i nh vy M t phm vi ca cc tnh trng hoc th thut y t b nh hng bi s phn i v lng tm.

Nh cung cp dch v ca qu v khng th phn bit i x vi qu v v qu v quyt nh a ra hoc khng a ra ch th trc. Nu qu v mun tm hiu xem cc nh cung cp dch v trong mng li ca Mercy Maricopa c thc hin theo cc kha cnh trong ch th trc hay khng, vui lng gi cho Dch v hi vin ca Mercy Maricopa theo s 6025861841 hoc 18005645465; (TTY/TDD) 711.


Ni vi gia nh v cc nh cung cp dch v ca qu v nu qu v a ra ch th trc. Cung cp cc bn sao ca ch th trc cho: Tt c cc nh cung cp dch v chm sc cho qu v, bao gm c nh cung cp dch v chm sc chnh

(PCP) ca qu v Nhng ngi m qu v ch nh theo giy y quyn chm sc sc khe y t hoc tm thn Cc thnh vin trong gia nh hoc bn b thn tn, nhng ngi c th gip cc bc s v cc nh cung cp dch

v chm sc sc khe hnh vi ca qu v a ra la chn cho qu v nu qu v khng th lm c iu

Hy lin h vi Dch v hi vin ca Mercy Maricopa hi thm v cc ch th trc hoc c gip lp mt ch th trc.

Thanh ton cho cc dch v chm sc sc khe ca qu v

Nhng ngi iu kin tham gia AHCCCS khng th b tnh ha n cho cc dch v chm sc sc khe hnh vi c bao tr. Nu qu v yu cu mt dch v m khng phi l phc li c bao tr v k vo mt tuyn b ng thanh ton ha n th qu v s phi thanh ton ha n. Nu qu v nhn ha n cho mt dch v chm sc sc khe hnh vi c bao tr, hy gi ngay cho nh cung cp dch v, ngi gi ha n cho qu v v cung cp cho h a ch lp ha n ca Mercy Maricopa:

Mercy Maricopa Integrated Care 4350 E. Cotton Center Blvd., Bldg. D Phoenix, AZ 85040

Mt s hi vin s phi thanh ton cc khon ng thanh ton cho mt s dch v nht nh nh c m t di y.

Cc khon ng thanh ton ca AHCCCS Mt s ngi nhn c cc phc li Medicaid ca AHCCCS phi thanh ton cc khon ng thanh ton i vi mt s dch v y t ca AHCCCS m h nhn c.

*LU : Cc khon ng thanh ton c tham chiu trong mc ny c ngha l cc khon ng thanh ton c tnh ph theo Medicaid (AHCCCS). iu ny khng c ngha l mt ngi c min cc khon ng thanh ton ca Medicare.

Nhng ngi sau y khng bao gi phi tr khon ng thanh ton: Ngi di 19 tui Nhng ngi c S dch v y t Arizona xc nh l mc bnh tm thn nghim trng (SMI) Cc c nhn t 20 tui tr xung iu kin nhn cc dch v t chng trnh Dch v phc hi chc nng

dnh cho tr em Nhng ngi l hi vin c chm sc cp tnh v ang c tr trong cc dng ng hoc cc c s c

tr nh C x sinh hot c tr gip v ch khi tnh trng y t ca hi vin c chm sc cp tnh cn nhp vin. Vic min cc khon ng thanh ton cho cc hi vin c chm sc cp tnh c gii hn 90 ngy trong mt nm hp ng

Nhng ngi c ghi danh vo H thng dch v chm sc di hn ca Arizona (Arizona Long Term Care System (ALTCS))

Nhng ngi l i tng th hng iu kin ca Medicare Nhng ngi nhn dch v chm sc dnh cho ngi hp hi Cc hi vin ngi M Da hin l ngi hoc tng l ngi s dng Dch v y t dnh cho Ngi Da ,

cc chng trnh y t dnh cho b lc c hot ng theo P.L. 93-638 hoc cc chng trnh y t dnh cho Ngi Da thnh th

Nhng ngi ang trong Chng trnh iu tr ung th t cung v ung th v (Breast and Cervical Cancer Treatment Program (BCCTP))


Nhng ngi ang nhn cc dch v phc li tr em theo Title IV-B trn c s a tr ang c chm sc nui dng hoc nhn con nui hoc h tr chm sc nui dng theo Title IV-E bt k tui

Nhng ngi ang mang thai v trong sut giai on hu sn sau thai k Cc c nhn thuc nhm Ngi ln (trong thi gian hn ch**)

**LU : Trong thi gian hn ch, nhng ngi iu kin trong nhm Ngi ln s khng c bt k khon ng thanh ton no. Hi vin trong nhm Ngi ln bao gm nhng ngi c chuyn i t chng trnh AHCCCS Care cng nh cc c nhn trong tui t 19 n 64, nhng ngi khng c hng Medicare, nhng ngi ang khng mang thai, nhng ngi c thu nhp bng hoc di 133% Mc ngho lin bang (FPL) v nhng ngi khng iu kin tham gia AHCCCS thuc bt k hng mc no khc. Khon ng thanh ton cho nhng ngi trong nhm Ngi ln c thu nhp trn 106% FPL c lp k hoch cho tng lai. Cc hi vin s c thng bo v mi thay i i vi khon ng thanh ton trc khi cc thay i din ra.

Ngoi ra, cc khon ng thanh ton khng bao gi c tinh cho cc dch v sau y cho bt ky ngi no: Nhp vin Cc dch v cp cu Cc ngun tip liu v dch v k hoch ha gia nh Dch v chm sc sc khe lin quan n thai k v dch v chm sc sc khe cho bt k tnh trng bnh l

no khc c th nh hng n thai k, bao gm iu tr cai thuc l dnh cho ph n ang mang thai Thm khm k lng v dch v phng nga chng hn nh pht t bo c t cung, soi rut gi v chng nga Cc dch v phng nga ca nh cung cp Cc dch v nhn c trong khoa cp cu

Ngi c khon ng thanh ton danh ngha (ty chn) Cc c nhn iu kin tham gia AHCCCS thng qua bt k chng trnh no di y u c th phi tr khon ng thanh ton danh ngha, tr khi: 1. H ang nhn mt trong cc dch v bn trn m khng phi tr khon ng thanh ton 2. H thuc mt trong cc nhm bn trn m khng phi tr khon ng thanh ton

Cc khon ng thanh ton danh ngha cn c gi l khon ng thanh ton ty chn. Nu mt hi vin c khon ng thanh ton danh ngha th nh cung cp khng c t chi dch v nu hi vin trnh by rng h khng c kh nng thanh ton khon ng thanh ton. Nh cung cp dch v c th tnh ph khon ng thanh ton danh ngha cho hi vin trong cc chng trnh sau y: AHCCCS cho cc gia nh c tr em (1931) Bo him chuyn tip ngi tr tui (Young Adult Transitional Insurance (YATI)) dnh cho tr em cn chm

sc nui dng H tr ngha dng ca tiu bang cho tr c nhu cu c bit ang c nhn nui Nhn Ph cp an sinh x hi (Supplemental Security Income (SSI)) thng qua c quan Qun l an sinh x hi

dnh cho nhng ngi t 65 tui tr ln, b khim th hoc khuyt tt Ch h tr y t SSI (SSI Medical Assistance Only (SSI MAO)) cho ngi t 65 tui tr ln, b khim th hoc

khuyt tt Quyn t do lm vic (Freedom to Work (FTW))

Yu cu nh cung cp dch v xem xt tnh iu kin ca qu v tm hiu cc khon ng thanh ton m qu v c th c. Qu v cng c th tm hiu bng cch gi cho dch v hi vin ca Mercy Maricopa. Qu v cng c th kim tra www.MercyMaricopa.org bit thm thng tin.

Cc hi vin tham gia AHCCCS c khon ng thanh ton danh ngha c th c yu cu thanh ton cc khon ng thanh ton danh ngha sau y cho cc dch v y t:

http:www.MercyMaricopa.org


S tin ng thanh ton danh ngha (ty chn) cho mt s dch v y t

Dch v Khon ng thanh ton

Thuc theo toa $2,30 Cc dch v ngoi tr dnh cho vt l tr liu, tr liu bng phng php vn ng v tr liu ngn ng $2,30

Thm khm ngoi tr ti vn phng bc s hoc nh cung cp khc nh gi v qun l dch v chm sc ca qu v $3,40

Cc nh cung cp dch v y t s yu cu qu v thanh ton cc khon ny nhng s KHNG t chi cung cp dch v cho qu v nu qu v khng c kh nng thanh ton. Nu qu v khng th thanh ton, hy cho nh cung cp dch v y t ca qu v bit rng qu v khng c kh nng thanh ton nhng khon ny khng b t chi dch v.

Nhng ngi c khon ng thanh ton c yu cu (bt buc) Mt s hi vin ca AHCCCS c cc khon ng thanh ton c yu cu (hoc bt buc) tr khi h ang nhn mt trong cc dch v bn trn v khng phi tr khon ng thanh ton hoc tr khi h thuc mt trong cc nhm bn trn v khng phi tr khon ng thanh ton. Hi vin c cc khon ng thanh ton c yu cu s cn thanh ton cc khon ng thanh ton nhn c dch v. Nh cung cp c th t chi cung cp dch v cho nhng hi vin ny nu h khng thanh ton cc khon ng thanh ton bt buc. Khon ng thanh ton bt buc c tnh cho nhng ngi trong Gia nh c tr em khng cn iu kin theo thu nhp na - cn c gi l H tr y

mercy maricopa integrated care

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