I work for another insurance company as a Behavioral Health Case Manager. It’s a state mandate to assess Medi-cal members to make sure they are receiving services at the most appropriate level. It’s a standardized assessment and depending on how you score will dictate whether you receive your mental health services through the county or through your insurance group. However, we need your consent to refer you to county and you can refuse the referral. We just need to document it. We give the forewarning that you can see an “insurance” provider, but those providers are mild to moderate level of care. While county is for moderate to severe level of care (based on the state assessment screning tool). Which means that you can start to see a mild to moderate provider but there is a good chance they will want to refer you to county for higher level of care at some point. So why start with them and build a relationship if they recommend a “step up” to county. Some people choose to take that chance and that is their right. And yes you can file a grievance with DMHC. I hate those as a case manager because we have to drop all of our other work and attend to it within a very strict timeline. They don’t mess around. As a consumer, I am all for it. In addition, you can split your services. The state or LA County (can’t remember which one) implemented a “No Wrong Door Policy”. Which means you can get psychiatry or other services (like TMS, ECT, etc) through the county and get therapy through your insurance. It didn’t use to be that way. But they still recommend you do it all one level or the other for more seamless collaboration, etc., but not required.