20-543 Behavioral Health Screening Referrals
Date: 07/28/20
This information applies to Physicians, and Participating Physician Groups (PPGs).
This information applies to Medi-Cal in Fresno, Kings and Madera 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 Medi-Cal 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
CalViva Health 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.
The network includes psychiatrists, psychologists, clinical social workers, psychiatric nurse specialists, and marriage and family therapists.
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.
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 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:
- 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 contained in this update, contact CalViva Health at 1-888-893-1569.