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Glossary
Care
Managers:
Trained MHP
employees who evaluate your needs, make provider referrals,
authorize and coordinate mental health care.
Core Service Agency:
Plans and manages services at the local
level.
Complaint:
Feedback
that you are unhappy about some aspect of the
PMHS.
Grievance:
A
disagreement with an individual or provider around level of service,
treatment, or any other relative matter, that you file to resolve
the situation. 2. A request from you or your provider
for MHP to review a decision they have made about the request for
services or the level of services that you are
receiving.
Managed Care
Organization (MCO):
Under
Medical Assistance, helps you get the care you need for physical
health.
Maryland Health
Partners (MHP):
Hired by MHA
to help you or someone you know get the mental health care
needed. Monitors and manages claims for payment to PMHS
providers. http://www.mdhp.com/
Medical Necessity Criteria:
Used to determine whether an appropriate
prescribed treatment is appropriate for consumer's
condition.
Mental Hygiene
Administration (MHA):
State
Department within the Department of Health Mental Hygiene that funds
and oversees the PMHS. www.dhmh.state.md.us/mha
Physician Advisors:
Physicians employed by MHP to assist Care Managers
in making and reviewing decisions about authorizations of mental
health services.
Medicaid:
State
funded medical insurance for recipients of Public
Assistance.
Medicare:
Federally
funded medical insurance for individuals over 65 or have Social
Security Insurance for over 24 months.
Abbreviations
CSA
- Core Service
Agency
LCSW (-C)
-
Licensed Clinical Social Worker (-Certified)
MCO -
Managed Care Organization
MHP
- Maryland Health
Partners
MHMA
- Mental Health
Management Agency
MA
- Medical
Assistance
DHMH -
The Maryland Department of Health and Mental
Hygiene
PMHS
- Maryland
Public Mental Health System
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