20-542 Behavioral Health Screening Referrals

Date: 07/28/20

This information applies to Physicians, and Participating Physician Groups (PPGs).

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 Cal MediConnect (Medicare-Medicaid Plan) 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 member to complete and send a copy back to MHN. Be sure to keep the signed form in the member’s medical records.

MHN manages inpatient and outpatient treatment for behavioral health and substance abuse care. The network includes psychiatrists, psychologists, clinical social workers, psychiatric nurse specialists, as well as psychiatric and substance abuse facilities and programs.

Prior authorization is not required for initial assessment for outpatient behavioral health services.

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 emergencies.
• 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

Check below for how to access the following online resources:

• Search for a BH provider in the MHN Provider Directory without calling MHN.
  • Go to www.mhn.com. Select For Members > Find a Provider> Choose the applicable Health Net Plan option for your member.
• BH resources to assess, monitor and treat depression are 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.
  • Go to the Health Net Provider Website. Select Working with Health Net > Quality > Behavioral Health Resources for Health Net Providers or Provider Tip Sheets.
• Use one either option below to access provider operations manuals for more BH details.
  • Option 1: Go to the Health Net Provider Website. Select Working with Health Net > Contractual > Policy Library > Go to the Provider Library. Select a Line of Business > Provider Manual > Benefits > Behavioral Health.
  • 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 regarding the information above, contact the Health Net Provider Services Center at:

Line of Business	Telephone Number	Email Address
Cal MediConnect – Los Angeles County	1-855-464-3571	provider_services@healthnet.com
Cal MediConnect – San Diego County	1-855-464-3572