Coordinating Care
Optum expects that you will seek to obtain the member’s consent to exchange appropriate treatment information with medical care professionals (e.g., primary physicians, medical specialists) and/or other behavioral health clinicians (e.g., psychiatrists, therapists). Coordination and communication should take place at the time of intake, during treatment, the time of discharge or termination of care, between levels of care and at any other point in treatment that may be appropriate. Optum forms available for use in the coordination of care include a Confidential Exchange of Information Form, which includes a release of information, and an Authorization for the Release of Information. Coordination of services improves quality of care to members in several ways:
- It confirms for a primary physician that his or her patient followed through on a behavioral health referral and is therefore receiving recommended services.
- It minimizes potential adverse medication interactions for members who are prescribed psychotropic medication.
- It allows for better management of treatment and follow-up for members with co-existing behavioral and medical disorders.
- It can reduce the risk of relapse with members in some populations, as with substance use disorders.
Best Practice Guidelines
Optum adopted Best Practice Guidelines from nationally recognized organizations. The guidelines define objective and evidence-based parameters of care. Links to these Best Practice Guidelines are available through www.providerexpress.com.
Supplemental and Measurable Guidelines
Optum has created Supplemental and Measurable Guidelines which provide objective evidence-based and measurable components to supplement the Best Practice Guidelines for selected conditions. Currently, there are three Supplemental and Measurable Guidelines that are presented here, along with corresponding recommended Best Practices and applicable Level of Care Guidelines.