Behavioral Health Services

Referring Participants for behavioral health services

Participants may self-refer for behavioral health services. However, primary care providers (PCPs) and other physical health care providers often need to recommend that a Participant access behavioral health services. The health care provider or their staff can find assistance for Participants needing behavioral health services by calling the toll-free numbers noted on the Behavioral Health Services Providers by County flyer listed on this page.

Cooperation between network providers and the behavioral health managed care organizations (BH-MCOs) is essential to help ensure Participants get appropriate and effective care.

Behavioral health and substance use services – by county

Requirements when working with BH-MCOs

Network providers are required to:

  • Adhere to state and federal confidentiality guidelines for Participant medical records. This includes obtaining any required written Participant consents to disclose confidential mental health and drug and alcohol records.
  • Refer Participants to the appropriate BH-MCO, once a mental health or drug and alcohol problem is suspected or diagnosed.
  • To the extent permitted by law, participate in the appropriate sharing of necessary clinical information with the behavioral health provider. This includes, if requested, all prescriptions the Participant is taking.
  • Be available to the behavioral health provider on a timely basis for consultation.
  • Participate in the coordination of care when appropriate.
  • Make referrals for social, vocational, educational, and human services when a need is identified through an assessment.
  • Refer to the behavioral health provider when it is necessary to prescribe a behavioral health drug, so that the Participant may receive appropriate support and services necessary to effectively treat the problem.

BH-MCO's role in care

The BH-MCO provides access to diagnostic, assessment, referral, and treatment services including but not limited to:

  • Inpatient and outpatient psychiatric services
  • Inpatient and outpatient drug and alcohol services (detoxification and rehabilitation)

Questions?

You can call Participant Services at 1-855-332-0729 if you need help referring a Participant for behavioral health services.

Providers