Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Behavioral Health)
Behavioral Health
Quality Improvement
Objectives (continued)
11-52
Exchange of Information with Primary Care Physicians
Routinely ask all new patients to authorize exchange of
information with primary care/specialty physicians.
Establish a distinct section in the treatment record, if one does
not exist, dedicated to case management activities. This section
should contain:
Documentation of patient authorization/refusal to exchange
information with the physician.
When authorized, documentation of communication with
the physician (e.g., report, letter, telephone or e-mail
communication).
When recommending a patient seek psychopharmacologic
treatment from his/her primary care physician or if the
patient’s primary care physician recommended mental
health assessment and/or treatment, provide the primary
care physician with the current behavioral health
diagnosis(es), diagnostic criteria (i.e., symptoms with
onset, duration and severity) and treatment plan, if
applicable.
When authorized, the treating psychiatrist or clinical
nurse specialist should provide the current diagnosis
(es) and initial medication management information to
the primary care/specialty physician. This requirement
is important for patient safety.
Appointment Accessibility
Provide routine initial appointments within ten business days
of the request.
Provide routine follow-up appointments within ten business
days of the initial appointment.
Provide urgent appointments within 24 hours of the request.
Provide non-life-threatening-emergency appointments within
six hours of the request.
Provide or facilitate life-threatening-emergency care
immediately.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12