20-541 Behavioral Health Screening Referrals
Date: 07/28/20
This information applies to Physicians, and Participating Physician Groups (PPGs).
For Medi-Cal, this information applies to Kern, Los Angeles, Sacramento, San Diego, San Joaquin, Stanislaus, and Tulare counties.
Use screening tools to help you decide when patients need to see an MHN provider
Primary care physicians (PCPs) are encouraged to screen members for depression and other behavioral health conditions. The screening tools below can help you identify conditions earlier and determine when to refer Health Net members for behavioral health (BH) services to Health Net’s behavioral health division, MHN.
BH condition | Screenings |
Anxiety | Generalized anxiety disorder-7 (GAD-7) is widely used. The Patient Health Questionnaire (PHQ) Screeners page is available for more information. |
Depression | Patient health questionnaire (PHQ-9) is most common and can be used for adolescents and adults. The Patient Health Questionnaire (PHQ) Screeners page is available for more information. |
Post-traumatic stress disorder (PTSD) | PTSD Screen for diagnostic and statistical manual of mental disorders (DSM-5) (PC-PTSD-5) is a five-step screen designed for use in primary care or other medical settings. Learn more about Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) from U.S Department of Veterans Affaris. |
Substance use | View the National Institue on Drug Abuse website for a list of evidence-based screening tools and assessment resources. |
Suicide | View the Ask Suicide-Screening Questions (ASQ) Toolkit on the National Institute of Mental Health website. |
MHN remains available 24 hours a day, 7 days a week
Health Net members may contact MHN for referrals to behavioral health counselors, local resources or telephonic consultations to help them cope with stress, grief, loss or other trauma. Members may contact MHN 24 hours a day, seven days a week by calling the member services telephone number listed on their identification card (ID).
Referrals to MHN
Members do not need to contact their PCP, participating physician group (PPG) or attending physician to request a referral for MHN services. Providers may also contact MHN for assistance with these services and referrals for behavioral health. Also, document the member has signed and authorized you to share confidential information with MHN as required by law. You may also ask MHN to send a copy of the Authorization for Disclosure of Protected Health Information for the appropriate line of business for that member to complete and send a copy back to MHN. Be sure to keep the signed form in the member’s medical records.
The network includes psychiatrists, psychologists, clinical social workers, psychiatric nurse specialists, marriage and family therapists1, and psychiatric and substance abuse facilities and programs.2
Prior authorization is not required for initial assessment for outpatient behavioral health services.
For commercial and Medicare Advantage (MA) HMO members, MHN manages inpatient and outpatient treatment for behavioral health and substance abuse care.
For Medi-Cal members, MHN manages:
- Outpatient treatment for mild-to-moderate behavioral health services
- Applied behavioral analysis (ABA) for members under the age of 21.
Routine BH services
For routine BH service requests, MHN notes the member’s needs, geographic area, benefit plan and scheduling requirements to identify a practitioner or program that meets the clinical needs of the member. Member preferences, such as gender and cultural experience, are considered when possible.
MHN meets the regulatory standards for BH services, which are available within:
- Six hours for non-life-threatening emergencies3
- 48 hours for urgent situations.
- 10 business days for routine services with a non-physician mental health provider.
- 15 business days for routine services with a psychiatrist.
Contact MHN for questions
PCPs and their office staff may call MHN customer service to speak with a licensed care manager (CM). MHN CMs can assist PCPs by discussing the behavioral health needs of their patients. MHN customer service staff are able to answer questions about MHN’s network and programs, the referral process, member eligibility and benefits. A signed Disclosure of Protected Health Information form is required for MHN to discuss member-specific eligibility, benefits or history of care.
Contact MHN at 1-888-935-5966 or email MHN.ProviderServices@healthnet.com for BH services.
Online resources
Find a BH provider for your member.
- Search for a BH provider in the MHN Provider Directory without calling MHN.
- Visit the MHN website. Select For Members > Find a Provider> Choose the applicable Health Net Plan option for your member.
Check grid below for how to access the following online resources:
- BH resources to assess, monitor and treat depression are available on the provider portal under the Quality Improvement (QI) Corner. View tip sheets, Screening Brief Intervention Referral to Treatment (SBIRT) for substance use disorder, Coordination of Care between Medical and Behavioral Health Providers Form and other tools under the QI Corner.
- Provider operations manuals for more BH details.
Use the table below to access BH information on the provider portals
If you need to access: | For a member | Go to: | Then: |
BH resources for alcohol/substance abuse, depressive symptoms and other BH conditions, and the MHN referral form | Individual MA, IFP CommunityCare, HMO, PPO, PureCare HSP, PureCare One EPO, and EnhancedCare PPO | Select product type on the Home screen; under Welcome, select Resources > Quality > Behavioral Health Resources for Health Net Providers.4 Or Select product type on the Home screen; under Welcome, select Resources > Quality > Provider Tip Sheets. | |
Employer group MA HMO, EPO, HMO, POS, HSP, PPO, EPO, and Medi-Cal
| Select Working with Health Net > Quality > Behavioral Health Resources for Health Net Providers.4 Or Select Working with Health Net > Quality > Provider Tip Sheets. |
Use either option below to access BH information in the provider operations manuals
Option 1
If you are serving members | Go to: |
Individual MA, IFP CommunityCare, HMO, PPO, PureCare HSP, PureCare One EPO, and EnhancedCare PPO |
|
Employer group MA HMO, EPO, HMO, POS, HSP, PPO, EPO, and Medi-Cal |
|
Option 2
- Go to the Health Net Provider Library.
- Select a Line of Business > Provider Manual > Benefits > Behavioral Health.
Additional Information
If you have questions about the information contained in this update, contact the Health Net Provider Services Center by email within 60 days, by telephone or through the Health Net provider website:
Line of Business | Telephone Number | Provider Portal | Email Address |
EnhancedCare PPO (IFP) | 1-844-463-8188 | provider_services@healthnet.com | |
EnhancedCare PPO (SBG) | 1-844-463-8188 | ||
Health Net Employer Group HMO, POS, HSP, PPO, & EPO | 1-800-641-7761 | ||
IFP (CommunityCare HMO, PPO, PureCare HSP, PureCare One EPO) | 1-888-926-2164 | ||
Medicare (individual) | 1-800-929-9224 | ||
Medicare (employer group) | 1-800-929-9224 | ||
Medi-Cal | 1-800-675-6110 | N/A |
1 Marriage and family therapists does not apply for Medicare Advantage (MA) HMO members.
2 Network psychiatric and substance abuse facilities and programs do not apply for Medi-Cal members.
3 Emergencies for Medi-Cal members are managed by the county.
4 This section also includes Screening Brief Intervention Referral to Treatment (SBIRT) for substance use disorder information and the Coordination of Care between Medical and Behavioral Health Providers Form.