Provider Referral Billing Expectations
For Hospitals, Clinics, and Community Partners
This page is intended for referring providers, hospitals, and community organizations to clarify billing scope, payer rules, and financial responsibility when referring individuals to Emergent Mental Health Services.
Overview of Billing Model
Emergent Mental Health Services operates under a Crisis-Lite outpatient model. Services are:
- Short-term and stabilization-focused
- Billed according to payer-specific outpatient behavioral health guidelines
- Not emergency, inpatient, or long-term psychotherapy services
Insurance & Authorization
- Services are billed only when rendered and documented in accordance with payer requirements.
- Insurance eligibility and coverage are verified when possible, but coverage is not guaranteed.
- Prior authorization requirements remain the responsibility of the payer and, when applicable, the referring entity.
Emergent Mental Health Services does not:
- Back-bill for services not rendered
- Guarantee insurance payment
- Assume financial responsibility for uncovered services
Copays & Client Responsibility
- Client copays, coinsurance, or deductibles are due at the time of service for both in-person and telehealth services.
- Clients are informed that financial responsibility remains with them if services are denied or not covered by insurance.
Referring providers should not represent services as “free” or “fully covered” unless confirmed directly by the payer.
Missed Appointments & No-Shows
- AHCCCS does not permit billing for missed or late-canceled appointments.
- Emergent Mental Health Services does not bill AHCCCS or referring entities for no-shows.
- Missed appointments may impact future scheduling availability for the referred individual.
Scope & Clinical Responsibility
Emergent Mental Health Services:
- Accepts referrals appropriate for Crisis-Lite outpatient care
- Does not provide inpatient admission, emergency detention, or long-term psychotherapy
- Does not assume ongoing clinical responsibility beyond services rendered
Referring entities retain responsibility for:
- Acute risk management prior to referral
- Emergency services when clinically indicated
- Continuity of care outside the Crisis-Lite episode
Communication & Care Coordination
When appropriate and permitted:
- We provide referral confirmation and attendance status
- We coordinate next-step referrals upon discharge from Crisis-Lite services
- We maintain clear role boundaries to avoid duplication or clinical ambiguity
Provider Acknowledgment Statement
By referring individuals to Emergent Mental Health Services, the referring entity acknowledges that services are Crisis-Lite, outpatient, and subject to payer rules, client eligibility, and attendance requirements. Financial responsibility for uncovered or missed services does not transfer to Emergent Mental Health Services.