Member Services Are All About You
When you are a member of a benefit plan through The Holman Group EAP or Behavioral Health program, you’re part of a caring, supportive, and confidential mental wellness support community. We give you access to the information, skilled providers, and emergency support you need when you need it.
In the Member Center, you’ll find useful tools, resources, and plan specific information that will help you live each day to the fullest.
If you would like to search for a mental health professional, you may access our provider database Find A Provider.
Member Rights and Access to Services
As a member of The Holman Group behavioral health program, you have the right to receive timely access to covered behavioral health services and to be treated with dignity, respect, and confidentiality.
Members may contact The Holman Group Member Services at (800) 321-2843 for assistance with:
- Accessing behavioral health services
- Locating an in-network provider
- Understanding plan benefits and coverage
- Requesting authorization for services
- Obtaining language assistance services
Grievance and Appeals
Members have the right to file a grievance if they are dissatisfied with any aspect of the services provided by The Holman Group or one of our providers.
Examples of grievances may include concerns related to:
- Access to care
- Quality of care
- Authorization decisions
- Claims processing
- Provider conduct
To file a grievance, please contact Member Services at (800) 321-2843 or visit our File a Grievance page.
If a grievance has not been resolved within 30 days, or if you need assistance with an urgent matter, you may contact the California Department of Managed Health Care (DMHC).
Additional information regarding the grievance process and Independent Medical Review (IMR) is available on our Grievance page.
Independent Medical Review (IMR)
Members may be eligible for an Independent Medical Review (IMR) if they disagree with a decision made by the health plan regarding:
- Medical necessity of a proposed behavioral health service or treatment
- Coverage decisions involving experimental or investigational treatments
- Payment disputes related to emergency or urgent services
The IMR process provides an independent review conducted by medical professionals who are not affiliated with the health plan.
To learn more about IMR or to request assistance, visit the Grievance page or contact the Department of Managed Health Care Help Center at 1-888-466-2219.
Language Assistance Services
The Holman Group provides free language assistance services to members whose primary language is not English.
These services include:
- Qualified interpreters
- Translation of vital documents
- Assistance communicating with providers and Member Services
To request language assistance services, please call (800) 321-2843.
Continuity of Care
Members currently receiving behavioral health services from a provider who leaves The Holman Group network may qualify for Continuity of Care, which allows members to continue treatment with their existing provider for a limited period of time under certain circumstances.
Examples of eligible situations may include:
- Acute behavioral health conditions
- Serious chronic behavioral health conditions
- Terminal illness
- Scheduled behavioral health treatment or programs
Additional information regarding eligibility and how to request Continuity of Care is available on our Continuity of Care page.
Utilization Management Transparency
Authorization decisions for behavioral health services are made based on medical necessity and applicable plan benefits.
The Holman Group does not provide financial incentives to staff or providers to deny coverage or services.
Members and providers may request information about the clinical criteria used to make authorization decisions by contacting Member Services at (800) 321-2843.
Provider Directory
Members can search for participating behavioral health providers using the Find a Provider directory.
If you need assistance locating a provider or scheduling services, please contact Member Services at (800) 321-2843.
Members may also report inaccurate provider directory information by contacting us.
Crisis and Emergency Support
If you are experiencing a behavioral health crisis or emergency:
- Call 911, or
- Go to the nearest emergency room immediately.
Members may also contact The Holman Group for behavioral health support at (800) 321-2843.
Emergency services do not require prior authorization.