Non-Covered Services

Chelan-Douglas Regional Support Network/
Prepaid Health Plan

For Mental Health

Chelan-Douglas RSN/PHP
636 Valley Mall Parkway,
Suite 200
East Wenatchee, WA 98802

509-886-6318
1-877-563-3678
Fax: 509-886-6320

Monday - Friday
8 AM - 5 PM

Non-Covered Services
Your Responsibilities
Consumer Disenrollment

Non-Covered Services within the Chelan-Douglas RSN/PHP are as follows:

	Inpatient Eating Disorders
	Sex Offender/Pedophile/Diagnosis
	Court Evaluations
	Antisocial Personality
	or, other conditions not deemed to be medically necessary or requiring mental health interventions.

Please note that this list may not be inclusive of all non-covered services and is subject to change. Always verify with the provider before the service is rendered regarding coverage.

Your Responsibility as a person receiving services, is to find out if you are eligible to receive public community funded mental health services, keep appointments and be responsive to services and recommendations.

Disenrollment happens with a Medicaid consumer when the consumer:

	Loses eligibility for Title XIX.
	On a case-by-case basis, the Mental Health Division will disenroll a consumer from his/her mental health prepaid health plan when the consumer has “good cause” for disenrollment.
	Good Cause is defined as the inability of the mental health prepaid health plan to provide medically necessary care that is reasonably available and accessible according to the WAC 388-865-0340 Consumer Disenrollment.

Crisis Line - 509-662-7105 or 1-800-852-2923

Chelan-Douglas Regional Support Network/ Prepaid Health Plan

Non-Covered Services Your Responsibilities Consumer Disenrollment

Chelan-Douglas Regional Support Network/
Prepaid Health Plan

Non-Covered Services
Your Responsibilities
Consumer Disenrollment