Behavioral Health Resources for PCPs Behavioral Health Partner
Behavioral Health Resources for PCPs
Behavioral Health Partner: Optum Customer Service Numbers: All. Ways Health Partners Commercial: 844 -451 -3518 All. Ways Health Partners Mass. Health/ACO: 844 -451 -3519 All. Ways Health Partners, Partners ASO: 844 -451 -3520 • Available via Provider Express at: https: //www. providerexpress. com/content/ope-provexpr/us/en. html Eligibility Verification Claims and Authorization Status Provider Information Resource Materials, Guidelines, and Tools For BH Appeals: Optum Appeals and Grievances P. O. Box 30512 Salt Lake City, UT 84130 -0512 Fax: 1 -855 -312 -1470 Phone: 1 -866 -556 -8166 All. Ways Health Partners includes All. Ways Health Partners, Inc. and All. Ways Health Partners Insurance Company. 2
Optum is a committed partner in coordinating and integrating care between medical and behavioral health services to improve patient outcomes • As the first line of defense for behavioral health issues, primary care providers play a critical role in the proper identification, treatment, and referral for BH conditions. • As a collaborative healthcare partner, Optum supports PCPs through information sharing and support so that they have the tools and resources they need to successfully treat these patients. • Optum’s BH Toolkit for Medical Providers has been created to support collaborative initiatives with primary care providers. All. Ways Health Partners includes All. Ways Health Partners, Inc. and All. Ways Health Partners Insurance Company. 3
Optum’s Toolkit Member Resources Training Videos Screening Tools Best Practices Provider Search Online Treatment Plans and Mental Health Referrals PHQ-2 and 9 Antidepressant Medication Management How to find Express Access or Virtual Visits Depressive Disorders Presentation & Treatment Birth to 5 Compendium of Screening Measures Alcohol and Other Substance treatment All. Ways Health Partners includes All. Ways Health Partners, Inc. and All. Ways Health Partners Insurance Company. SUD Resources Substance Use Disorder Helpline 1 -855 -780 -5955 A 24/7 helpline for providers and patients to: • Identify local MAT and behavioral health treatment providers and provide targeted referrals for evidence-based care • Educate members/families about substance use • Assist in finding community support services • Assign a care advocate to provide ongoing support for up to 6 months, when appropriate 4
PCPs can access the toolkit from Optum’s provider page 1. Go to https: //www. providerex press. com/content/opeprovexpr/us/en. html 2. Click on Clinical Resources 3. Click on “Behavioral Health Toolkit for Medical Providers Many additional resources and trainings are available on this provider site All. Ways Health Partners includes All. Ways Health Partners, Inc. and All. Ways Health Partners Insurance Company. 5
BH Screening Tools for PCPs ASQ: SE BITSEA CRAFFT ECSA EPDS M-CHAT-R/F PEDS PHQ-9 Behavioral Health Screening Tools Administered by Ages and Stages Questionnaire: Social-Emotional www. brookespublishing. com/asq Brief Infant and Toddler Social and Emotional Assessment http: //www. pearsonclinical. com/psychology/products/100000150/brief-infant-toddler-social-emotionalassessment-bitsea. html Parent Age Group 6 to 60 months Parent 12 to 36 months Youth 14 to 21 years Parent 18 to 60 months Parent 0 to 6 months Parent 16 to 30 months Parent Birth to 8 years Youth 13+ years Car, Relax, Alone, Forget, Friends, Trouble (specific to substance/alcohol use) http: //www. ceasar-boston. org/CRAFFT/ Early Childhood Screening Assessment http: //www. infantinstitute. org/measures-manuals/ Edinburgh Postnatal Depression Scale (new as of March, 2017) http: //www. fresno. ucsf. edu/pediatrics/downloads/edinburghscale. pdf Modified Checklist for Autism in Toddlers (specific to autism)—for dates of service through 12/31/17 only— effective 1/1/18, only the MCHAT-R can be used www 2. gsu. edu/~psydlr Modified Checklist for Autism in Toddlers (revised with follow-up) www 2. gsu. edu/~psydlr Parents’ Evaluation of Developmental Status www. pedstest. com Patient Health Questionnaire-9 (screening for depression) http: //www. integration. samhsa. gov/images/res/PHQ%20 -%20 Questions. pdf PSC/PSC-17 Pediatric Symptom Checklist or 17 -question version* (*new as of March, 2017) www. massgeneral. org/psychiatry/services/psc_home. aspx Parent 4 to 16 years PSC-Y Youth 11 to 18 years PSC-17 SDQ Pediatric Symptom Checklist – Youth Report www. massgeneral. org/psychiatry/services/psc_home. aspx Pediatric Symptom Checklist Strengths and Difficulties Questionnaire (www. sdqinfo. org Parent 3 to 16 years SDQ Self-Rated SDQ (www. sdqinfo. org ) Youth 11 to 16 years Parent 0 to 60 months ) SWYC or Survey of Wellbeing of Young Children (standard or Massachusetts specific version) SWYC-MA www. The. SWYC. org All. Ways Health Partners includes All. Ways Health Partners, Inc. and All. Ways Health Partners Insurance Company. Additional Tools and Quality Initiative information available at https: //www. provi derexpress. com/c ontent/opeprovexpr/us/en/cli nicalresources/clinicaltools-and-qualityinitiatives. html 6
Integrated Care Management Offered at All. Ways Health Partners • Your Care Circle(YCC) v The YCC program is designed to provide individualized, coordinated support and care management to members of all ages who are experiencing a range of medical, psychological, and social health challenges. v A holistic and multidisciplinary approach to care management, Care Managers work as part of an interdisciplinary team and visit members in their homes, during hospitalizations, shelters or other public venues. v Each interdisciplinary team is comprised of a Medical Care Manager, Behavioral Health Care Manager, Social Care Manager and Community Health Workers. The program aims to increase engagement with these historically hard-to-reach members through the use of novel approaches (e. g. , home visits, phone calls, letters, hospital visits, community health workers) and meet a member’s biopsycho-social healthcare needs to improve overall quality of life v Referrals can be made via secure/confidential email at Yourcarecircle@allwayshealth. org, include member name and All. Ways Health Partners ID, referring person contact information and a brief description of why you are referring (issues, concerns, needs). All. Ways Health Partners includes All. Ways Health Partners, Inc. and All. Ways Health Partners Insurance Company. 7
How Might This Programs Impact You? • Contact with the PCP should occur for all members* enrolled in these programs (*if the member has signed a release of information to speak with his/her PCP) • You may have information which is crucial to include in a member’s care coordination plan • If you don’t have a relationship with the member (i. e. , have never met the member), the YCC CM will work with the member to schedule an appointment with you as soon as possible • The YCC team can assist with things like referrals to behavioral health services, setting up transportation to appointments, etc. – this can save you valuable time!!! All. Ways Health Partners includes All. Ways Health Partners, Inc. and All. Ways Health Partners Insurance Company. 8
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