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Please check that the following documents are included in the submission:
If determined to be eligible for SMI services, the T/RBHA will assign the applicant to an SMI clinic. Applicants can choose which clinic they would like to attend.
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 |
Care 1st | 1-602-778-1800 |
Magellan Complete care | 1-800-424-5891 |
Mercy Care | 1-602-263-3000 |
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 |
Navajo Nation | 1-928-871-6235 |
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:
Northern Arizona:
Central Arizona:
Southern Arizona:
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.
Members need to use behavioral health services properly. It is considered fraud if a member or provider is dishonest in order to:
Abuse happens if a member causes unnecessary costs to the system on purpose, for example:
Misuse of your AHCCCS identification card, including loaning, selling or giving it to others, could result in your loss of AHCCCS eligibility. Fraud and abuse are felony crimes and are punishable by legal action against the member or provider.
CRN has a zero tolerance policy against fraud, waste and program abuse.
If you think somebody is committing fraud or abuse, please contact the AHCCCS, Office of Inspector General: 602-417-4193. For more information visit the AHCCCS Contacts page here.
ECS 1.01 Initial Submission to CRN 1.9.20
ECS 2.01 Criteria for SMI Eligibility 3.17.20
ECS 2.01A SMI Qualifying Diagnosis 031617
ECS 2.01B Substance Use and Psychiatric Symptomatology Table
ECS 2.02 SMI Eligibility Determination Process 1.9.20
ECS 2.03 Decertification Process 7.14.20
ECS 3.01 Appeals and Notices Requirements 11.03.20
ECS 4.02 Release of Information 3.17.20
ECS 5.01 Record Requirements 3.17.20
ECS 11.02 SMI Evaluation and Packet – Data Quality and Training Requirements 08.11.20
If you have any questions about the ECS Provider Dashboard or wish to schedule a training on the SMI Packet Submission Process, please email the ECS team at SMItraining@crisisnetwork.org or call 855-832-2866.
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