Your Rights and Responsibilities

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.

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.