Member Services

If you receive Mental Health or Substance Use Disorder services through the Fresno County Behavioral Health Plan, this page explains your rights and how to get help.

If you need this information in another language, large print, or another format, please call 1-800-654-3937 (TTY 711).


Member Handbook & Important Notices

These documents explain your benefits, rights, and how to access services.


Language Assistance & Accessibility

Free language assistance services and accessible formats are available at no cost.

This includes interpreters, translated materials, and information in large print or other accessible formats.

Please review the Language Assistance Notice below or contact us if you need help.


Member Handbooks

Notice of Significant Change

All notices are available in large print (20-point font) to support accessibility.


File a Grievance (Complaint)

What is a grievance?

A grievance is a complaint about your care, provider, or services.  It is not about a Notice of Adverse Benefit Determination (NOABD).

You may file a grievance:

  • At any time
  • By phone, mail, or in person
  • Orally or in writing
  • Yourself, through a provider, or through an authorized representative

We will:

  • Send written confirmation within  5 calendar days
  • Send a written decision within 30 calendar days
How to File:

Call: 1-800-654-3937 (TTY 711)
Mail:
Fresno County Department of Behavioral Health
P.O. Box 45003
Fresno, CA 93718-9886

Grievance Brochure/Form (English)


File an Appeal

What is an appeal?

An appeal is a request to review a decision described in a Notice of Adverse Benefit Determination (NOABD).  A NOABD is a written notice that explains a decision about your behavioral health services, such as a denial, delay, reduction, or termination of services.

You must request an appeal within 60 calendar days from the date on the NOABD.

You may file an appeal:

  • Orally or in writing
  • Yourself, through a provider, or through an authorized representative
  • If a provider files on your behalf, written consent is required

We will:  After we review your appeal, we will send you a Notice of Appeal Resolution (NAR) that explains our decision.

  • Send written confirmation within 5 calendar days
  • Send a decision within:
    • 30 calendar days (standard appeal)
    • 72 hours (expedited appeal) if waiting could seriously affect your life, health, or ability to function
How to File:

Call: 1-800-654-3937 (TTY 711)
Mail:
Fresno County Department of Behavioral Health
P.O. Box 45003
Fresno, CA 93718-9886

Appeal Brochure/Form (English).docx(DOCX, 69KB)


Access & Care Protections

Change of Provider

If you want to request a different behavioral health provider, you may submit a Change of Provider request. This option is based on your needs, preferences, and provider availability.

If your concern is about keeping your current provider during a transition, see Continuity of Care.

Continuity of Care

If you are currently receiving services and are concerned about a disruption in care, you may be eligible for Continuity of Care to continue seeing your current provider for a limited time.

If you are requesting a new provider, see Change of Provider.

 

 


Non-Discrimination Notice

Fresno County Behavioral Health Plan does not unlawfully discriminate.  If you believe you have been treated unfairly because of race, color, national origin, age, disability, sex, or other protected characteristics, you may file a discrimination complaint.


Patients' Rights & Advocacy

If you need help understanding your rights or filing a complaint: 

Patients' Rights Advocate

1-800-654-3937 (TTY 711)

 


We offer a variety of mental health services for people of all ages and backgrounds. If you’re not sure where to start or how to access treatment, you can learn more by reading our frequently asked questions below:

Member FAQ

Who do I call to get Mental Health Services?

Call the Fresno County Behavioral Health Access line at 1 800 654-3937 This number is available twenty-four hours a day seven days a week.


How do I apply for Medi-Cal?

You must contact the Fresno County Department of Social Services at 1 855 832-8082. An eligibility worker will assist you with your eligibility questions.


How do I find out if my Medi-Cal has been approved?

You may contact the Fresno County Department of Social Services at 1 855 832-8082 for information on your Medi-Cal status. An eligibility worker will be able to assist you. You may also call their automated system at (559) 600-1377 for information 24/7.


How do I file a complaint (Grievance)?

You may file a grievance if you are not satisfied with your Mental Health or Substance Use Disorder services. A grievance is a complaint about any matter other than a Notice of Adverse Benefit Determination (NOABD).

A grievance may be filed orally or in writing by:

  • a member,
  • a provider, or
  • an authorized representative.

You may file a grievance at any time by:

  • completing a grievance form available at any service site and mailing it to:
    Fresno County Department of Behavioral Health
    P.O. Box 45003
    Fresno, CA 93718-9886
  • or by calling 1-800-654-3937.

We will send you written confirmation within 5 calendar days of receiving your grievance and a written decision within 30 calendar days.

 

 

What kind of services (treatment) can I get at Mental Health Plan?

A wide variety of services are available including, counseling, medication, and case management for adult, children and families. Call 1 800 654-3937 for referrals to specific services.


What is a Fair Hearing?

What is a Fair Hearing?

A State Fair Hearing is part of the Medi-Cal appeals process. You may request a State Fair Hearing if:

  • you do not agree with an appeal decision, or
  • the Behavioral Health Plan does not resolve your appeal within required timeframes.

You must request a State Fair Hearing within 120 calendar days from the date of the written Notice of Appeal Resolution (NAR).

You can request a hearing by contacting:
California Department of Social Services
State Hearings Division
P.O. Box 944243, Mail Station 9-17-37
Sacramento, CA

 

 

More Information