Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member: Primary and secondary diagnoses; Findings from assessments; Medication prescribed; Psychotherapy prescribed; and Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contr...
Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable.
Behavioral Health Care Coordination. The Contractor must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor must have policies and procedures to facilitate the reciprocal exchange of social, physical and behavioral health information between physical and behavioral health providers treating the member. Given the State’s commitment to increasing the levels of Primary Care Behavioral Health Integration across its care infrastructure, the Contractor shall develop strategies that will allow for the expansion of care coordination, data reporting, and outcomes measurement.
Behavioral Health Care Coordination. The CONTRACTOR shall provide care coordination for members with multiple and complex special physical, mental, neurobiological, emotional and/or behavioral health care needs on an as needed basis, depending upon the clinical profile of the member. The CONTRACTOR shall have written policies and procedures, approved by HSD, which govern how members with these multiple and complex needs shall be identified and how these specific care coordination services shall be provided.
Behavioral Health Care Coordination. The Contractor must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor must have policies and procedures to facilitate the reciprocal exchange of social, physical and behavioral health information between physical and behavioral health providers treating the member. Given the State’s commitment to increasing the levels of Primary Care Behavioral Health Integration across its care infrastructure, the Contractor shall develop strategies that will allow for the expansion of care coordination, data reporting, and outcomes measurement. The Contractor must contractually mandate that its behavioral health care network providers notify a member’s Contractor within five (5) calendar days of the member’s visit,
