Frequently Asked Questions for Providers
What does it mean to be determined SMI or eligible for SMI services?
Serious Mental Illness (“SMI”) is a description used in Arizona for people who need additional support because their mental illness impacts their ability to function.
What is looked at (criteria/qualifications) to diagnose someone or determine if they qualify for SMI services?
To be eligible for SMI services (to get an SMI determination) a person must have both an SMI diagnosis and functional impairment caused by the qualifying diagnosis.
An individual may be appropriate for an SMI evaluation if the person may:
- Be unable to feed, clothe or bathe themselves, find a safe place to live, or get needed healthcare.
- Not understand that they need to, or may refuse to take care of their health. Other people might have to do any of these things for them.
- Have trouble in roles with others including having problems in their relationships.
- Have a hard time getting and/or staying in school or getting and/or keeping a job.
- (In the past or currently) be thinking about or actually be hurting or harming themselves or others.
- Be thinking about dying or killing themselves.
- Have used crisis services like going to the emergency room or calling the crisis line.
- Have needed to go into the hospital one or more times because of mental illness.
- Feel out of control, have a hard time following laws or rules, or have a hard time acting in ways that a lot of people would consider “normal.”
- Be using drugs or alcohol to deal with mental or physical conditions.
Other qualifications include:
- The person should be at least 17.5 years old and live in Arizona or plan to live in Arizona
- The person has been diagnosed with one or more SMI eligible conditions (see SMI form)
- The person can have both an SMI and non-SMI diagnosis, and still be SMI eligible.
- The person may have a history of mental health treatment, like outpatient medication management, counseling, or inpatient psychiatric hospitalization.
- The person has severe problems functioning in one or more areas, because of the SMI eligible conditions (CRN psychologists determine if this is due to the SMI diagnosis or a different condition)
How can I improve the success of a clinical staffing conducted regarding my members undergoing the SMI determination process?
- Provide more than one clinical contact.
- Provide accurate contact information for clinical contacts.
- Clinical contacts ought to be the clinicians who are most familiar with the member’s day-to-day functioning.
- Take note of potential upcoming vacation time for the clinical contact. Provide a backup contact if they are to be out.
- Ensure your voicemail is accepting messages and has a clear greeting identifying that it is your line.
- Return clinical staffing messages within 24 hours maximum. CRN has very limited time to render a decision!
- Indicate the best method to be reached (email/phone).
- Provide your accurate, honest perspective in the evaluation packet.
How do I request/ask for an evaluation for SMI services?
If you would like to be assessed for SMI services, please contact your assigned AHCCCS Complete Care (ACC) Plan. Your ACC Plan or provider will then arrange for a qualified assessor to meet with you and complete an application for SMI services:
|Arizona Complete Health||1-800-788-4408|
|Banner University Family Care||1-833-318-4146|
|Magellan Complete Care||1-800-424-5891|
|Steward Health Choice Arizona||1-800-322-8670|
|United Healthcare Community Plan||1-800-348-4058|
|Gila River Behavioral Health Services||1-888-484-8526|
|White Mountain Apache Behavioral Health Services||1-928-338-4811|
If you are not currently assigned to an ACC Plan, contact the T/RBHA in your region:
Steward Health Choice Arizona
For hearing impaired, use Arizona Relay Service at 711 or 1-800-367-8939
Hearing impaired TTY/TDD 711
Arizona Complete Health
Hearing impaired TDD/TTY 1-877-613-2076
If you are already receiving services with an AHCCCS provider, you may ask your provider to submit an application for SMI services.
If you are a provider, you may submit applications through this website on the SMI Assessment Submission Portal page.
What if I don't want SMI services anymore?
SMI services are voluntary. You may choose not to receive services. Or, you can ask your clinical team about closing or dis-enrolling.
We are here to help in this process; please contact us if you have any questions and/or need technical assistance.