Magellan Health

For Providers

Notice of Action vs. Notice of Decision

Understanding the differences between a Notice of Action (NOA) and a Notice of Decision (NOD).   

Notice of ActionNotice of Decision

In general, a NOA is a notice that must be issued to a Title 19/21 eligible individual whenever a request for a Title 19/21 covered service is denied, or whenever an existing Title 19/21 service is terminated, suspended or reduced.

For more detailed information regarding the NOA, please refer to Section 5.1 of the Provider Manual.

In general, a NOD is a notice that must be issued to a person determined to have a serious mentally illness (SMI) whenever the individual's service plan is developed, reviewed or modified. This includes, but is not limited to, situations where a request for an SMI service is denied, or where an existing SMI service is terminated, suspended or reduced.

For more detailed information regarding the NOD, see refer to Section 5.5 of the Provider Manual

If you need to send an NOD, please click here.

Of course, many individuals determined SMI are also Title 19. As a result, there will be many situations where the requirements for both a NOA and a NOD are met.  In these situations, only the NOA is issued.

It is important to note that individuals who are not Title 19/21 eligible and who are not determined to have a serious mental illness do not receive notices. However, they do have the right to appeal. For more information regarding this process, please refer to page 5.5-2 of the Provider Manual.

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Contact Information

Mercy Maricopa Integrated Care (Mercy Maricopa) is now the Regional Behavioral Health Authority (RBHA) serving members in the Maricopa County Region. For questions regarding your services, please call 1-800-564-5465 or TDD/TTY 711.

** To file a grievance or appeal for services provided on or before March 31, 2014 please call Magellan Health Services 602-652-5907, x8590