Your Rights and Responsibilities | Carelon Behavioral Health of Washington

When accessing behavioral health services through Carelon Behavioral Health, Washington residents have the following rights:

To be treated with respect and dignity
To have your privacy protected
To help develop a plan of care with services to meet your needs
To participate in decisions regarding your mental health care
To receive services in an accessible location
To request information about names, location, phone numbers, and languages for local agencies
To be free from seclusion or restraints
To receive age and culturally appropriate services
To be provided a certified interpreter and translated material at no cost to you
To understand available treatment options and alternatives
To refuse any proposed treatment
To receive care that does not discriminate against you (e.g. age, race, type of illness)
To be free of any sexual exploitation or harassment
To receive an explanation of all medications prescribed and possible side effects
To make an advance directive that states your choices and preferences for mental health care
To receive quality services that are medically necessary
To file a grievance
To file an appeal based on a written Notice of Action
To file a request for an administrative (fair) hearing
To request and receive a copy of your medical records and ask for changes. You will be told the cost for copying.
Be free from retaliation
You may also contact the Office of Civil Rights for more information at http://www.hhs.gov/ocr

Mental Health Ombuds

The Ombuds service provides free and confidential help when you have a concern or complaint about your mental health services. It is independent of Carelon Behavioral Health. The Ombuds service can help you with the grievance and appeals system. It can also help you file and assist you during an Administrative Fair hearing.

Southwest Washington (Clark, Skamania, and Klickitat Counties), please contact the Ombuds David Rodriguez at 509.434.4951 or via email at Southwestern@obhadvocacy.org.
- SWWA Ombuds Brochure 2020
- SWWA Ombuds Brochure 2020 (Spanish Version)
North Central Washington (Chelan, Douglas, Grant, and Okanogan Counties), please contact via email at Northcentral@OBHAdvocacy.org; Advocate is TBD.
Pierce County, please contact the Ombuds Kim Olander at 253.304.7355 or via email at Piercecounty@OBHAdvocacy.org.

Fraud and Abuse

To report suspected Medicaid fraud and abuse, please contact the Carelon Behavioral Health Director of Program Integrity:

In person by calling 757-744-6513.
By confidential fax to 757-459-7589.
By email at Program.IntegrityReferrals@carelon.com
By mailing a written concern to:
- Compliance and Ethics Hotline
  Norfolk Operations Center
  240 Corporate Boulevard, Suite 100
  Norfolk, VA 23502
By anonymous call to the toll fee Fraud and Abuse Prevention Hotline 888-293-3027.