ACCESS ALLIANCE OF MICHIGAN REGIONAL PROVIDER MANUAL
Bay-Arenac Behavioral Health Authority, Regional Pre-Paid Inpatient Health Plan
Chapter 5
Section 5.2
The Member Services Function
Member Services Provider-Related Policies
Section 5.2.1 Consumer Orientation Policy and Procedure
Page 1
Customers shall be oriented to all services and functions provided by the PIHP and all affiliates
Definitions :
Customer: Refers to those persons who are eligible to receive services as well as those currently receiving services, their families, and other referral sources.
For New Customers:
1. All customers who call Access to request services will be provided with an initial orientation process by the Access staff providing a scripted verbal overview that reviews recipient rights, complaint resolution process, grievance and appeal process, Medicaid fair hearing, second opinion requests, Person Centered
Planning and Self Determination. (See attachment-Customer Orientation Script).
2. All customers deemed eligible for services through the PIHP will become enrolled and directly linked to the appropriate provider or instructed on how to physically access services for their first time.
3. When the customer has their first appointment, the provider is responsible for continuing the orientation process. This includes reviewing and giving the customer the following: a.
Customer handbook for the AAM/Affiliate b.
Provider directory c.
Description of benefits d.
Information on Michigan Department of Community Health Medicaid Fair
Hearing (for Medicaid recipients only) e.
Grievance and appeal process written description f.
Recipient Rights Handbook g.
Complaint Resolution process description h.
Fiscal policies as appropriate for Ability to Pay, Medicaid Spend down, and coordination of benefits. i.
Peer Assistance Program and Self Determination j.
Substance abuse handbook and equivalent, if applicable k.
Brochure on “Advanced Directives in Michigan” l.
Other useful items to support customers
4.
All material given to customers should be at a sixth grade reading level or as defined by the DCH contract and Federal Regulations.
Bay-Arenac Behavioral Health
Access Alliance of Michigan
Riverhaven Coordinating Agency
Huron Behavioral Health
Montcalm Center for Behavioral Health
Shiawassee County Community Mental Health
Tuscola Behavioral Health Systems

ACCESS ALLIANCE OF MICHIGAN REGIONAL PROVIDER MANUAL
Bay-Arenac Behavioral Health Authority, Regional Pre-Paid Inpatient Health Plan
Chapter 5
Section 5.2
The Member Services Function
Member Services Provider-Related Policies
Section 5.2.1 Consumer Orientation Policy and Procedure
Page 2
5.
Customers will be provided the opportunity to receive written materials in alternative formats and access to non-English interpretive services free of charge.
For Current Customers:
1. The above information/materials (A-L) and the phone number of the AAM
Customer Services Department will be made available in all provider locations in recommended mediums of consumer handbooks, posters and websites. All staff will have a basic understanding of the purpose of AAM Customer Services and how to refer an individual to that department.
2.
Customers will receive notification of any updates as they occur, upon request and annually
Evaluation:
The customer’s input is important. The effectiveness of the orientation program shall be determined via customer feedback/ratings on the customer satisfaction surveys conducted by the PIHP in addition to tracking and evaluation of customer complaints that are related to lack of orientation. See attached policy regarding satisfaction surveys.
Bay-Arenac Behavioral Health
Access Alliance of Michigan
Riverhaven Coordinating Agency
Huron Behavioral Health
Montcalm Center for Behavioral Health
Shiawassee County Community Mental Health
Tuscola Behavioral Health Systems