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Patient FAQ

What is Human Behavior Institute?

HBI is a behavioral health organization delegated by various insurance groups to administer behavioral health services.

Do I need a referral from my physician?

No, you don't.  Simply call for an appointment.  HBI will work closely with your physician when necessary.

Do I need an authorization?

Authorization is dictated by your insurance plan.  Some plans automatically authorize a certain number of visits, and some require authorization from the first visit.  Check with your health plan regarding authorization, or call HBI Intake Department at (702) 248-8866 option 1 for clarification.

How do I obtain a referral/authorization?

Call the member services/mental health services telephone number on the back of your member ID card.

Do I need authorization for psychological testing?

Coverage is determined by your insurance plan.  As a general rule, psychological testing may require prior authorization.

What if my provider or I did not obtain an authorization for services?

Most insurance plans will deny claims if services are not authorized.  Under certain situations, they may allow a restricted retroactive review.  For clarification, call HBI Intake Department at (702) 248-8866 option 1.

I want my child to be tested for ADHD.

Such requests usually come from an MD or a teacher.  Testing is not processed automatically. Most plans require a screening assessment by a specialist before such a procedure is done.

My child was already screened by the school district.  Testing was recommended for ADHD and educational issues.  However, the waiting period is too long.  I would prefer to use my insurance plan.

Educational assessment is generally not covered by most insurance plans.  Once a recommendation for testing is made by a school counselor or psychologist, the school has a designated period of time to complete such an evaluation. Ask your school counselor about the designated time frame.

What about confidentiality?

It is important that HBI personnel and providers protect confidential patient information from being disclosed.  HBI staff members follow all applicable local, state, and federal laws and regulations with respect to maintaining confidentiality.  We work to protect your confidentiality through the following procedures:

  • Only personnel that have a direct need to know basis have access to a patient's record.
  • Computers at HBI can only be accessed with the employee's personal password.
  • All HBI personnel sign a confidentiality statement at the time of hire.
  • All providers sign an agreement to maintain patient confidentiality.
  • HBI will not share your information without your written permission, unless it is required by law.  In some cases, a legal guardian must give their permission. 
  • We will share information as permitted by law if your safety or the safety of others is a concern. 
  • HBI follows and complies with HIPAA standards.

My employer established an Employee Assistance Program with HBI.  Do I need an authorization?

No.  Just call the HBI telephone number given to you by Human Resources to schedule an appointment. 

How do I release my records?

Records are shared with your permission (or a legal guardian's).  You or your guardian needs to sign a consent form granting your permission for such a release.  Records may be released without your consent when your safety or the safety of others is in jeopardy or required by Federal or State laws.

Can I see my treatment records?

Please speak with your provider who will arrange for a time to review your records. 

Can I have a copy of my records?

Be aware that if you need a copy of your records, there may be a fee.

What criteria do you use when denying or limiting services?

HBI uses national and in-house standards when evaluating level of care services.  These criteria are periodically reviewed and updated and must be approved by HBI's Quality Management Committee.

Can I appeal a denial?

Members/providers can appeal denials for reconsideration.  You can request an appeal either verbally or in writing.  At the time of denial, you will receive a form explaining the appeal process.  You can file these appeals with the HBI Utilization Management (UM) Coordinator.

What about complaints?

A complaint can be made by an enrollee, a guardian, a provider, a health plan, or a governmental entity.

How do I file a complaint?

You can file a complaint either verbally or in writing.  Send your complaint to HBI Member Services by completing a request for service.

What if I want to change my therapist?

Counseling is essentially a relationship between the client and the therapist/clinician.  In the event you want to make a change, please contact HBI's patient coordinator at extension 222 and an appropriate change will be made.

If you have any questions that were not answered above, Contact Us.  We are here to help.