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Provider Manual

Continuity and coordination in care

Last Updated on August 28, 2018

Security Health Plan believes its members should receive seamless, continuous, and appropriate care through communication between behavioral health providers and primary care providers. The Health Insurance Portability & Accountability Act (HIPAA) privacy regulations supports Security Health Plan’s interest in patient safety and coordination of care.

When patients present for behavioral health care, they need to be informed about how their records will be handled and, in certain circumstances, to give consent or authorization regarding what information can be shared and with whom. Coordination of care reduces the risk of problems when patients see multiple providers in different settings and when providers lack access to the patient’s complete medical record. Important mental health information to be shared would include patient diagnosis, medication and/or treatment plan.

In Security Health Plan’s effort to provide high quality health care, affiliated behavioral health providers are required to communicate with primary care providers. Security Health Plan monitors this activity through an annual provider survey sent to both behavioral health providers and primary care providers. Providers indicate if they believe it is important to share this information as well as, if the sharing of this information occurs.

Security Health Plan appreciates help and cooperation in this matter to improve communication between providers through continuity and coordination of care.

Policy

Security Health Plan ensures mechanisms are in place for timely, effective, and confidential exchange of information between behavioral health (BH) providers and primary care providers (PCP), medical/surgical specialists, and other relevant medical delivery systems.

Procedure

Security Health Plan establishes and maintains systems that assess the frequency and substance of information to be exchanged, based on the usage of the patient signed consent allowing exchange of information between their health care providers. Examples of monitoring activities may include:

  • Surveys of BH providers regarding the exchange of health care information between BH providers and other providers
  • Surveys of PCPs regarding information provided to and from BH providers
  • Review of PCP medical records to determine if PCPs receive BH specialist feedback, such as BH hospitalization discharge summaries
  • Assessment of member protection of privacy between BH and medical providers