Aetna Better Health of California is committed to coordinating medical and behavioral care for members who will be appropriately screened, evaluated, treated and referred for physical health, behavioral health or substance use disorder, dual or multiple diagnoses or developmental disabilities. With the member’s permission, our case management staff can facilitate coordination of case management related substance use screening, evaluation, and treatment.
Members seen in the primary care setting may present with a behavioral health condition, which the Primary Care Providers (PCPs) must be prepared to recognize. PCPs are encouraged to use behavioral health screening tools, treat behavioral health issues that are within their scope of practice and refer members to behavioral health providers when appropriate. Members seen by behavioral health providers are screened for co-existing medical issues. Behavioral health providers will refer members with known or suspected and untreated physical health problems or disorders to their PCP for examination and treatment, with the member’s consent. Behavioral health providers may only provide physical health care services if they are licensed to do so. Mental Health/Substance use (MH/SUD) providers are asked to communicate any concerns regarding the member’s medical condition to the PCP, with the members consent if required, and work collaboratively on a plan of care.
Information is shared between Aetna Better Health of California behavioral health and medical providers to verify interactions with the member result in appropriate coordination between medical and behavioral health care.
The PCP and behavioral health provider are asked to share pertinent history and test results within 24 hours of receipt of results in urgent or emergent cases, and notification within 10 business days of receipts of results for non-urgent or non-emergent lab results.