Parity FAQ for Addiction and Mental Health Consumers

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Arizona 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 Arizona.

Attorney General
For information concerning filing a complaint, click here.

Consumer Guide to the Health Care Appeals Process in Arizona
Consumer Guide to Appeals Process

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 Arizona Health Plans:

 

Aetna

Submit claim form to
Aetna
PO Box 14463
Lexington, KY 40512

Blue Cross Blue Shield of Arizona

Go here for forms, addresses and phone numbers

Cigna

Call the Member Service number on the back of your Cigna Healthcare ID card

Health Choice

File either in writing or over the phone
Call: (480) 968-6866 (Maricopa Coutny)
(800) 322-8670
Mail to:
Health Choice Arizona
Attn: Member Grievances
410 N. 44th Street, Suite 900
Phoenix, AZ 85008
Or
Health Choice Arizona
Attn: Member Appeal
410 N. 44th Street, Suite 900
Phoenix, AZ 85008

Health Net Life Insurance (PPO) and Health Net of Arizona (HMO)

Call Customer Service: (800) 977-7522
Mail to:
Health Net of Arizona
Health Net Member Appeals and Grievances
PO Box 279419
Sacramento, CA 95827
Fax: (800) 977-6855

To file online click here

Humana

Humana Grievances and Appeals
P.O. Box 14165
Lexington, KY 40512–4165
Fax: 1(800) 949–2961
Call: 1(800) 457-4708
Grievance/Appeal Request form here

Phoenix Health Plans

Call (602) 824-3900 or (888) 864-1114

UnitedHealthcare

Call Customer Service: (866) 633-2446

 

State Regulators


Insurance Commissioner

Arizona Department of Insurance
Interim Director
2910 N. 44th Street, Suite 210
Phoenix, AZ 85018
Phone: (602) 364-3100
Fax: (602) 364-3470

 

Utilization Management Appeals

Arizona Department of Insurance, Life & Health Division
2910 N. 44th Street, Suite 210
Phoenix, AZ 85018
Phone: (602) 364-2393
Fax: (602) 364-2175

 

External Review Appeals

Arizona Department of Health Services
Bureau Chief
2910 N. 44th Street, Suite 210
Phoenix, AZ 85018
Phone: (602) 364-2499

 

Parity Appeals

Arizona Department of Insurance, Life & Health Division
Director, Department of Insurance
2910 N. 44th Street, Suite 210
Phoenix, AZ 85018
Phone: (602) 364-2393

 

Additional Arizona 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