ADVANTAGE Care Select works with providers to ensure that members with behavioral
health needs receive additional support to manage their conditions. Our goal is
to help our members manage their mental health or substance abuse disorders for
increased quality of life and fewer severe medical issues.
Through Disease Management and Care Management, patients with behavioral health
needs have an advocate that will help them access the resources they need. We work
with them, as well as you, their provider, to ensure that they have a treatment
plan that meets their needs.
ADVANTAGE Care Select Disease Managers will consult with both the member’s
physical and behavioral health providers, when a gap in care is discovered, to facilitate
the sharing of clinical information, and the development of a coordinated physical
health and behavioral health treatment plan for the member. Information will be
exchanged only as permitted by law and in accordance with the member’s consent.
If you have an ADVANTAGE Care Select patient with a behavioral health need
– or a patient you suspect has a problem – please contact our Disease
Management Department. We will reach out to those patients and offer help.
Behavior Health Problems
- » Mental Health Disorder
- » Substance Abuse Disorder
Members with a mental health disorder are at a higher risk of also having a substance
use disorder and vice versa. Members that are suspected of having either a mental
health disorder or substance abuse disorder should be screened for the other.
- » Members with mental health disorders should be screened for substance
- » Members with substance abuse disorders should be screened for
mental health disorders
What to expect if you refer a patient
- » Your patient will be contacted by a Disease Manager and complete
a basic health assessment
- » Disease Management will review assessment results, the member’s
claims history and the member’s current health status to develop a care plan
with health care goals and interventions
- » You may be contacted for additional clinical information or be
notified that the patient needs care
- » You will receive a copy of the care plan
- - Your patient will have an advocate that will coordinate their care
by accessing any/all the community resources that they need and communicating with
all care providers
- - We engage patients in their treatment plan for improved outcome
- - Once a year, you may be invited to participate in a conference call
with an ADVANTAGE Care Select Disease Manager to discuss the member’s
Call Disease Management at (800) 784-3981 to refer an ADVANTAGE Care Select
member for behavioral health services.
The following two screening tools may assist you in determining whether a member
should be referred for a Behavioral Health assessment.
- » K6: Screening tool to determine whether an adult may have
a mental disorder
- » The Pediatric Symptom Checklist is a well-established tool
that assesses behavioral, social and developmental needs for children and adolescents