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PROVIDER MANUAL AND ALERTS
IMPORTANT CONTACTS
IVR AND EXTENSION SCREENS
ELECTRONIC CLAIMS
REPORTS AND SUPPORT MATERIALS
INFORMATION FOR PCCs
MASSHEALTH ELIGIBILITY
INTEGRATED CARE MANAGEMENT SERVICES
OUTCOMES MANAGEMENT
CURRENT BENEFIT SERVICE GRID
ELECTRONIC FUNDS TRANSFER (EFT)
CSA WORKING DOCUMENTS
QUALITY MANAGEMENT
RAPID ADMISSION INCENTIVE



Integrated Care Management Services

MBHP's care management system aims to expand access to services and promote the integration of medical, mental health, and substance use disorder care for Members. This more comprehensive approach targets the individual needs of Members and provides them with one point of contact into the health care system.

Integrated Care Management Program (ICMP): ICMP is an enhanced care management program offered to Members with complex medical, mental health, and/or substance use disorders. Five (5) regional service centers with clinical staff (licensed, master's-level clinicians and registered nurses) will provide integrated medical and behavioral health care management which may include direct face-to-face care management visits with Members. Please call MBHP at 1-800-495-0086, Ext. 454165 if you have a patient you'd like to refer to ICMP. Click here to download a provider brochure about ICMP. Click here to download a Member brochure about ICMP.

Who will be eligible for the ICMP?
Members in MBHP's current Intensive Clinical Management (ICM) program as of October 1, 2012 will transition over to the ICMP. In addition, a predictive modeling tool will analyze behavioral health, medical, and pharmacy claims data (historical and current) to identify Members with the highest need for integrated physical and behavioral health services and care coordination. The ICMP will also accept referrals from providers and Members.

The ICMP staff will notify you if you are a PCC and have a Member(s) in your panel identified for the ICMP and then again upon enrollment into the program. For Members already receiving care management/coordination services in another program (i.e., Children's Behavioral Health Initiative, Patient-Centered Medical Home Initiative), the ICMP staff will work with you to ensure that there is coordination, not duplication of services.

MBHP is actively seeking referrals from providers for Members to participate in ICMP. To make a referral please click here to access the interactive ICMP referral form, click here to download a PDF of the ICMP referral form, or call
1-800-495-0086, Ext. 454165 for more information.

ICMP Webinars September 2013
A Webinar about the Integrated Care Management Program (ICMP) was held for hospital care coordinators, discharge planners, quality staff, medical social workers, administrative staff, and others who might benefit from learning about the ICMP and how it can serve as a resource for transition of care and care coordination of high-risk Members. Presenters included Nancy Norman, MD, Medical Director of Integration at MBHP, Kate Flanagan-Helmes, Vice President of the ICMP, and George Smart, Vice President of Clinical Operations at MBHP. To access a recording of the Webinar, click here. You will need to either enter the e-mail address you used when registering for the Webinar (if you attended live), or all of your contact information (if you did not attend live). Once you have entered your information, you will be taken to the recording. If you have questions or need support accessing this Webinar, contact erin.donohue@valueoptions.com.
To download the Webinar slides as a PDF, click here.

Health Needs Assessment (HNA): The Health Needs Assessment (formerly known as the Health Risk Assessment) is a series of questions designed to gather information about a Member's health needs. Members can complete the HNA online through MBHP's web portal available through www.masspartnership.com, or a Member Engagement Specialist may provide direct assistance to the Member, as needed, in completing the HNA.

Other Resources

Care Coordination provides supportive services for Members who are having difficulty transitioning from hospitalization to community-based services. Care Coordination reviews the care Members are currently receiving to ensure that it is the most appropriate and coordinates treatment services to support their recovery. Care Coordination also monitors the provision of the Member's medical care. This includes ensuring treatment compliance with any chronic conditions and developing a crisis prevention plan with the Member to reduce further hospitalizations.

Community Support Program (CSP) is available to any MBHP Member. The program is composed of community-based agencies, which provide outreach and wraparound services to Members. To improve their health status, CSP care managers work closely with Members to support their care plans and link them to local health care and support resources.

Referral Forms



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Link SymbolThird Party Liability (TPL) FAQs
 Click here for Frequently Asked Questions about MBHP's Provider Alert #126 regarding Third Party Liability.

Link SymbolExpedited Authorization Website
 An Expedited Authorization and Mental Status Update website is available for all eligible Emergency Service Program providers starting June 1, 2012: please click here to connect.

Link SymbolMBHP has gone Green!
 Notices of new routine authorizations, and the letters themselves, are available at the MBHP/ValueOptions online provider portal ProviderConnect. Letters related to adverse actions or denials continue to be sent through the mail. To hear a previously presented training on the authorization letter Go Green program click here.

Link SymbolChildren's Behavioral Health Initiative (CBHI)
 Please click here for information, including performance specifications, for Children's Behavioral Health Initiative (CBHI) services.

Link SymbolFile Electronic Claims
 Learn more about the advantages of submitting electronic claims.

Link SymbolRights for Your Members
 Information on rights, appeals, and grievances for your Members

Link SymbolContact MBHP
 We're here to answer your questions and address your concerns.

Link SymbolMassHealth Provider Services Department
 1-800-841-2900
Primary Care referral sources, community resources, and acute and Urgent Care Services Facilities

 

 

 

MBHP - Massachusetts Behavioral Health Partnership
1000 Washington Street, Suite 310, Boston, MA 02118-5002 : 1-800-495-0086
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This page was last updated: 11/25/2013