Phone: 833-689-0542
BSMH Network Exception Waiver

If an in-network provider or facility does not provide the complex service a member may need, the referring provider may use the Network Exception Waiver to request a network exception before the member receives care. If the out-of-network provider or facility is approved, the provider will be considered at the Tier 2 level of benefits for the date span of the approved waiver.

Referring Provider Instructions
Instructions for referring providers to submit the online waiver.

BSMH Network Exception Waiver FAQ
Detailed information about the waiver, waiver submissions, status inquiries, etc.

Member need help?

Rightway Health Guides can answer questions about the member’s BSMH Medical Plan, help them find in-network providers and facilities, and book appointments. To learn more, visit Rightway Healthcare or call 833-689-0542 Monday-Friday 8 a.m. to 11 p.m. EST and Saturday-Sunday 9 a.m. to 5 p.m. EST.

Important notices

  • To verify if the provider is in network, visit go.umr.com/BSMH and search for the provider under the member’s plan. Please see the BSMH Network Exception Waiver FAQ above for further information.
  • If you have questions about what tier the provider is in, call 833-689-0542 Monday-Friday 8 a.m. - 11 p.m. EST and Saturday-Sunday 9 a.m. - 5 p.m. EST.
  • Extended Plan only: Waivers do not apply to the Extended Plan. Excluded providers do not apply to the Extended Plan. Gap exceptions may be requested by the member if there are no in-network providers available within 50 miles of the member. The member should sign in to umr.com using their BSMH member ID, hover over Claims drop-down, select Other tools, then select Find a form to access the BSMH Gap Exception form. 

About us
UMR is a third-party administrator (TPA), hired by your employer, to help ensure that your claims are paid correctly so that your health care costs can be kept to a minimum and you can focus on well-being.

UMR is not an insurance company. Your employer pays the portion of your health care costs not paid by you.

UMR is a UnitedHealthcare company.

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