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Crisis Response Network, Inc. (CRN) is responsible for reviewing all applications for SMI services and making these determinations for the state of Arizona.
A person can request to be evaluated/considered for SMI services. The person must make a request through their provider or their AHCCCS provider. When a request is made, the provider will then complete an evaluation and an SMI Assessment Packet for each person. The Provider will then send the completed SMI Assessment Packet to CRN. CRN will then review the packet and determine whether the individual is eligible for SMI services by following the State?s guidelines/criteria.
CRN follows the State?s guidelines/criteria to determine SMI eligibility:
The provider must complete an assessment within seven (7) days after the request is made. The provider sends the completed packet to CRN within one (1) business day.
CRN has three (3) days after receiving the packet and all the information they need to review and make a decision (determination) about whether the person is eligible for SMI services. CRN must make a decision based on the information we get from the provider. This means that if information is missing or a packet is not complete CRN may determine that you are not eligible for SMI services (this mostly happens when CRN does not receive records from past providers).
You can chose to forfeit your right to a decision in three (3) days to give providers more time to send CRN all of the information we need to make the best decision. You have two choices:
CRN will send you a letter by mail to let you know what the final decision on your SMI determination is. This letter is called a Notice of Decision. If CRN finds that you are not eligible for SMI services, the letter will tell you why. If you do not get the letter/notice by the end of the time you agreed to (three (3), 20 or 90 days), please call CRN at 855-832-2866.
If your letter says that you DO qualify for SMI services,?CRN will notify Arizona Health Care Cost Containment System (AHCCCS), the T/RBHA and your provider.
An individual, their guardian, designated representative or family member can ask his/her current AHCCCS provider ?or? they can call the T/RBHA to ask for an SMI Determination.
An evaluation is required to occur no later than seven days after a request is made.
The individual meets with a qualified assessor.
The assessor sends the required paperwork (assessment) to CRN.
CRN has either three, 20, or 90 days to make the determination depending on each individual case.
After a decision has been made, a notice is sent to the individual with the results (determination) and how to receive services (when applicable).
Each applicant has the right to appeal their SMI determination.
To appeal, an individual must fill out and send the appeal form and include the original determination (decision). Or, they can call CRN and file by phone at 855-832-2866.
The individual will be able to meet with a second reviewing psychologist in an informal meeting within seven days of filing the appeal. Any additional information about the individual?s treatment history will be considered.
CRN will make the second decision within three to 20 days depending on the need for more information.
The individual will get a notice in writing with the final decision.
If the individual wishes to appeal the second decision, they have the right to ask for an administrative hearing.
I was not feeling great, but after speaking with a specialist, I do feel great. It put a lot of things I’ve been dealing with into perspective. Thank you for having this line. I really appreciate it.”
Serious Mental Illness (“SMI”) is a description used in Arizona for people who need additional support because their mental illness impacts their ability to function.
To be eligible for SMI services (to get an SMI determination) a person must have both an SMI diagnosis and functional impairment caused by the qualifying diagnosis.
– Provide more than one clinical contact.
– Provide accurate contact information for clinical contacts.
– Clinical contacts ought to be the clinicians who are most familiar with the member’s day-to-day functioning.
– Take note of potential upcoming vacation time for the clinical contact. Provide a backup contact if they are to be out.
– Ensure your voicemail is accepting messages and has a clear greeting identifying that it is your line.
– Return clinical staffing messages within 24 hours maximum. CRN has very limited time to render a decision!
– Indicate the best method to be reached (email/phone).
– Provide your accurate, honest perspective in the evaluation packet.
If you would like to be assessed for SMI services, please contact your assigned AHCCCS Complete Care (ACC) Plan. Your ACC Plan or provider will then arrange for a qualified assessor to meet with you and complete an application for SMI services:
|Arizona Complete Health||1-800-788-4408|
|Banner University Family Care||1-833-318-4146|
|Magellan Complete care||1-800-424-5891|
|Steward Health Choice Arizona||1-800-322-8670|
|United Healthcare Community Plan||1-800-348-4058|
|Gila River Behavioral Health Services||1-888-484-8526|
|White Mountain Apache Behavioral Health Services||1-928-338-4811|
If you are not currently assigned to an ACC Plan, contact the T/RBHA in your region:
If you are already receiving services with an AHCCCS provider, you may ask your provider to submit an application for SMI services.
If you are a provider, you may submit applications through this website on the SMI Assessment Submission Portal page.Notice of Privacy Practices
SMI services are voluntary. You may choose not to receive services. Or, you can ask your clinical team about closing or dis-enrolling.
The best way to make sure that the SMI Determination is done right and as quickly as possible is for you to be prepared. If you can, have?as much information with you as possible to the SMI evaluation meeting. Things that are helpful are:
The letter (SMI Notice of Decision) that Crisis Response Network will send you will include information on your rights to appeal the decision if you do not agree with the SMI eligibility determination. Applicants have 60 days from the date of the decision to appeal the decision. The letter will also include a form that can be completed and mailed to CRN to file an appeal, or you can appeal by phone by calling CRN at 855-832-2866.
After an appeal has been received, CRN will schedule an informal meeting with you to discuss your SMI eligibility determination and review any new records or information that may impact the SMI eligibility determination. If, after the informal meeting, CRN determines you do not meet SMI criteria, you then have the right to request an Administrative Hearing with an Administrative Law Judge. Requests for Administrative Hearings must be made in writing and sent to Arizona Health Care Cost Containment System (AHCCCS) at the following address:
Behavioral Health Grievance and Appeals
701 E. Jefferson Street, Mail Drop 6200
Phoenix AZ 85034