Whom should I call if I have a question about the family respite contract process?
Please contact the Director of Contract Services at
817-569-4136 or Michele.Mendez@mhmrtc.org.
What kind of monitoring can I expect, and how often?
Monitoring is scheduled at least annually, with a minimum of 5% of the consumer records being reviewed. Further questions about contract monitoring can be directed to the
Contract Monitoring Coordinator at (817) 569-4458.
Whom should I contact if I have a question about my Explanation of Benefit report?
Contact Provider Relations at providerrelations@mhmrtc.org.
Who should I contact to determine the status of a claim?
Contact Provider Relations at providerrelations@mhmrtc.org.
How does MHMR handle utilization management?
Utilization Management authorizes and monitors the provision of medically necessary care to eligible clients in need of services in a consistent, cost efficient and timely manner. It assists clients in receiving the least restrictive level of care indicated and with the least disruption to their lives.
How are claims processed?
Providers submit claims to MHMR for pre-approved services that have been rendered, preferably in an electronic file format. Claims are matched against a prior Authorization Number for approval for payment. An Explanation of Benefit Report is mailed to providers to reveal the status of each claim.
How does MHMR monitor its contracts?
Staff monitors internal and contracted providers' adherence to applicable rules, regulations, standards and laws utilizing standardized protocols and review instruments. Random and scheduled on-site audits are conducted to assess the quality and appropriateness of ongoing service provision. Monitoring and reporting activities emphasize the review of service and clinical outliers, as well as compliance with contractual reporting and billing requirements.
How does MHMR ensure quality with its providers?
Quality Management is designed to support the continuous quality improvement processes to enhance the mental health and intellectual development of people in our community. Quality Management establishes an internal framework for the design, development, coordination, integration and implementation of system-wide performance improvement and other quality enhancing activities.