Parity FAQ for Addiction and Mental Health Consumers

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Arkansas Parity Resources

Depending on whether you are filing a complaint or appeal, the contact information below should be able to help you if you have any questions.

Consumer Advocates


For general information about filing a parity appeal for mental health or addictions services, you cannot go wrong with contacting one of the consumer advocates below. Each has years of experience helping consumers in the state of Arkansas.

Arkansas Attorney General
For information regarding insurance complaints, click here.

Arkansas Medicaid
Hotline for assistance: 501-682-8622

Health Plan Contacts


When filing an appeal for the first time, you should contact your health plan’s customer service support line or check out their information online.

If you choose to appeal an adverse benefit determination concerning your mental health or substance use treatment or benefits, please keep in mind that the timeframe to do so varies by state, plan type, and other factors. Contact your state’s department of insurance for additional information.

Here is some contact information for Arkansas Health Plans:

 

Arkansas Blue Cross and Blue Shield

Appeals Coordinator of Arkansas Blue Cross and Blue Shield
PO Box 2181
Little Rock, AR 72203-2181
Fax: (501) 378-3366

 

Health & Wellness Solutions,  Centene/Ambetter of Arkansas

Customer Service: (877) 617-0390
Mail:
Health & Wellness Solutions, Ambetter of Arkansas
Member Services Department
PO Box 26440
Little Rock, AR 72221

 

QualChoice and QCA Health Plan

QualChoice
PO Box 25610
Little Rock, AR 72221
Phone: (501) 228-7111 or (800) 235-7111

 

UnitedHealthcare of Arkansas

Call Member Service number on the back of member ID card
Medicare Solutions:
UnitedHealthcare Customer Service
PO Box 29675
Hot Springs, AR 71903-9802

 

State Regulators


Insurance Commissioner

Arkansas Insurance Department
Insurance Commissioner
1200 West Third Street
Little Rock, Arkansas 72201-1904
Phone: (501) 371-2600
Fax: (501) 371-2618
insurance.consumers@arkansas.gov

 

Utilization Management Appeals

Arkansas Department of Health, Division of Health Resources
Director, Utilization Review Certification Program
5800 West Tenth Street, Suite 400
Little Rock, Arkansas 72204
Phone: (501) 661-2771
Fax: (501) 661-2165

 

External Review Appeals

Arkansas Insurance Department
Administrative Analyst
1200 West Third Street
Little Rock, Arkansas 72201
Phone: (501) 371-2831

 

Parity Appeals

Arkansas Department of Health, Division of Health Resources
Director, Utilization Review Certification Program
5800 West Tenth Street, Suite 400
Little Rock, Arkansas 72204
Phone: (501) 661-2771
Fax: (501) 661-2165

 

Additional Arkansas Insurance Administration Contacts, click here.

 

Federal Regulators


The federal government also can be a helpful resource if you are enrolled in a self-funded plan, Medicare, Medicaid or another type of insurance that is overseen at least in part by a federal agency. For definitions and filing information refer to the Parity Resource Guide

U.S. Department of Health and Human Service’s website on the Affordable Care Act health reform law

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA)

(SAMHSA) Implementation Mental Health Parity Addiction Equity Act

U.S. Centers for Medicare and Medicaid Services (CMS) U.S. Department of Labor, Employee Benefits, Security Administration (EBSA) or toll-free hotline: 1.866.444.EBSA (3272)

For the U.S. Department of Health and Human Services & Centers for Medicare and Medicaid Services list of exempt state and local plans, please email NonFed@cms.hhs.gov. You may ask them if any particular state and local plan has opted out of MHPAEA.

Information on requirements of employer-based insurance coverage and self-insured health plans. EBSA has benefit advisors who are available to answer questions and provide assistance in obtaining your benefits.

Consumer Guide to Disclosure Rights: Making the Most of Your Mental Health and Substance Use Disorder Benefits

 

Veteran and Military Resources


Veterans and military personnel can use these resources to get help or more information with their medical or behavioral health complaints.

Health Net Federal Services

A grievance is a written complaint or concern about a medical provider.
Click here for specific information regarding who, what and how to file.

TRICARE

View the recently released Tricare Mental Health Fact Sheet.

The appeal process is different based on the benefit issue. Depending on your issue, you can file a:
  • Factual appeal
    • This is if you were denied payment for services or supplies you received, or if payment was stopped for services or supplies previously authorized.
  • Medical necessity appeal
    • This is if prior authorization for care or services was denied because it was not deemed medically necessary. Medically necessary means it must be appropriate, reasonable, and adequate for your condition.
  • Pharmacy appeal
    • This is if you don't agree with a decision made about your pharmacy benefit. For example, Express Scripts denies your pharmacy claim.
  • Medicare-TRICARE appeal
    • This is if you're eligible for both TRICARE and Medicare, and Medicare denies your services or supplies.

If your care is denied, you should receive a letter with details about how to file your appeal.

Veterans Health Administration

Complaints are initially handled through the Patient Advocate.
Patient Advocate can be contacted at your local VA Medical Center.

Questions


If you have any additional questions about parity compliance, please contact info@paritytrack.org