Primary Care Referral Assistance
Primary care providers will occasionally need assistance in connecting their patients to a behavioral health care provider. Primary care providers will receive education and guidance on how to use the ASO to get their patients connected to the care that they need. The plan for providing this education and guidance has not been determined.
Depending on the circumstances, the primary care provider has a number of options for facilitating access to a behavioral health provider. In many situations, it may be sufficient for the primary care provider to provide a member with the ASO's customer service number and the member can call directly for referral assistance. In other situations, the primary care provider may wish to provide more direct assistance by contacting the ASO customer service line and obtaining referral information on behalf of the client or by using the ASO's web-based provider search engine.
In still other circumstances, the primary care provider may be concerned that a member has a need for behavioral health services, but that the member either has not connected to care in the past, or is unlikely to follow through on a referral. In this case, the primary care provider can call the customer service line and ask to speak with the ASO's director of care management (?). Together they can problem solve as to what approach would best to help a member connect to care. This could include assigning an Intensive Care Manager or a peer engagement specialist to work with the member directly.
Note: The Departments will consider in the course of ASO contract negotiations the feasibility of offering appointment assistance to all members that request behavioral health referrals. At a minimum, the ASO will invite members to call back if the referrals that the ASO provides are not accepting appointments. In the latter case, the ASO would offer to assist with appointment scheduling when the member calls back.
*Highlighted sections were revised.