Member Rights and Responsibilities
What are my rights and responsibilities while getting behavioral health services?
You have the right to:
- Be treated fairly and with respect regardless of race, ethnicity, religion, mental or physical disability, sex, age, sexual preference, or ability to pay,
- Participate in making your Service Plan,
- Include any persons you wish in your treatment,
- Have your protected health information kept private,
- Get your services in a safe place,
- Make an advance directive,
- Agree to or refuse treatment services, unless the services are court ordered,
- Get information in your own language or have it translated,
- File a complaint, appeal or grievance without penalty,
- Receive good care from providers who know how to take care of you,
- Choose a provider within the Provider Network,
- Use your rights with no negative action by the Arizona Department of Health Services or NARBHA, and
- The same civil and legal rights as anyone else.
You also have the right to request and obtain the following information at any time:
- Receive a Member Handbook at least annually from your provider (Responsible Agency) or NARBHA;
- The name, location, and telephone number of the current providers in your service area that speak a language other than English and the name of the language(s) spoken,
- The name, location, and telephone number of the current providers in your service area that are not accepting new members,
- Any limits of your freedom of choice among network providers,
- Your rights and protections,
- A description of how after-hours and emergency coverage is provided,
- A description of what is an emergency medical condition and what are emergency and post stabilization services,
- The process for getting emergency services, including the use of the 911 telephone system or local emergency numbers,
- The location of providers and hospitals that provide emergency and post stabilization services,
- Your right to use any hospital or other setting for emergency care,
- Your right to get emergency services without prior approval,
- The amount, duration, and scope of your benefits,
- The process for getting services, including approval requirements,
- The extent to which, and how, you may get benefits from out-of-network providers,
- The rules for post stabilization care services,
- Cost sharing, if any,
- How and where to access services including any cost sharing required and how transportation can be provided,
- Advanced directives,
- The structure and operation of the Arizona Department of Health Services,
- Physician incentive plans, and
- The grievance, appeal, and fair hearing procedures and timeframes.
To request any of this information, contact NARBHA Member Services at (928) 774-7128 or toll-free at 1-800-640-2123; for hearing impaired, please use the Arizona Relay Service at 711 or 1-800-367-8939 or internet assistance at http://www.azrelay.org/.
Rights for Individuals with a Serious Mental Illness in Arizona's Public Behavioral Health System
Individuals determined to have a Serious Mental Illness(SMI) in Arizona have many rights under the law. Many of these rights are listed in administrative rules commonly referred to as the "SMI Rules." You can find the rules in the Arizona Administrative Code, Title 9, Chapter 21. To learn more about rights for individuals with a serious mental illness in Arizona's behavioral health system, click here.
What are my responsibilities?
You have the responsibility to:
- Give information needed for your care to your providers;
- Follow instructions and guidelines from your providers;
- Know the name of your Clinical Liaison;
- Schedule appointments during regular office hours when possible limiting the use of Urgent Care and Emergency Room facilities;
- Arrive on time for appointments;
- Tell providers if you have to cancel an appointment before the scheduled time;
- Participate in creating your Service Plan;
- Be aware of your rights;
- Assist in moving towards your recovery;
- Take care of yourself; and
- Treat others with respect and work cooperatively with others.
Click here for more information on Rights & Responsibilities