Behavioral Health Unit

Substance abuse is a wide spread problem. Many times, the PCP is the first professional to encounter a patient with alcohol or other drug abuse issues.

The Health Plan suggests a few points for practitioners to consider when encountering patients who may be experiencing problems with alcohol and other drug dependence.

What PCPs Can Do:

• Carefully ask about alcohol and other drug use and screen for problem use.
• Make sure the diagnosis is listed in the patient chart and on your claims.
• Follow-up with the patient. Schedule a follow-up appointment or schedule an appointment with a qualified Behavioral Health clinician. Make sure that a substance abuse diagnosis is included on each follow-up visit. Patients may want to minimize their substance abuse, so persistence is required in raising the topic and keeping it at the forefront of a patient’s care.
• Encourage the patient to follow through. Express interest in his/her progress.
• Make a clear statement about needing to cut down if use is problematic. Give advice.
• Consult The Health Plan Substance Abuse Guideline which includes various screening tools.

Practitioners need to be mindful that substance abuse can co-occur with other Behavioral Health problems such as major depression or anxiety disorder, which can make treating substance abuse or diagnosing a behavioral health disorder more difficult. In instances like this, referral to a Behavioral Health provider is prudent. Practitioners looking to refer a patient for Behavioral Health services or to facilitate coordination of services should call the Behavioral Health Unit at 1.877.221.9295 for assistance. Additional resources on substance abuse can be found at www.nida.nih.gov.

The Health Plan recognizes that there are extenuating and emergent situations where psychotherapy and psychopharmacological interventions must take place through a telephone intervention. When a situation arises where a telephone intervention must take place, please call The Health Plan as soon as possible to report this information. Claims for these services should be billed with the appropriate CPT code, and a “GT” modifier. If you have any questions concerning telephone interventions, call the Behavioral Health Unit at 1.877.221.9295.

The Behavioral Health Unit is pleased to announce that effective immediately we will be offering Depression Disease Management for members diagnosed with Major Depressive Disorder. If you have a patient who you feel may benefit from the program or if you have any questions about the program, contact the Depression Disease Manager at 1.877.221.9592.

If you would like to refer a member to the Depression Disease Management program, you may do so on the web by going here.