2013 Practitioner and Provider Manual - Presbyterian Healthcare ...

Pharmacy9. Behavioral Health9. Behavioral HealthBehavioral health is the overarching term thatrefers to an array of mental health and substanceabuse clinical management services that combinethe best traditional approaches to health caredelivery with innovative, emerging solutions tosupport members in achieving their recovery goals.In addition to our Commercial and Medicarebehavioral health services, with the creation ofPresbyterian Centennial Care, the New MexicoHuman Services Department now contracts withmanaged care organizations to deliver the fullrange of physical health, behavioral health, andlong-term care in a comprehensive and integratedmanner.As a long-time health plan and health servicedelivery provider across New Mexico, we are wellaware of the need to maintain a trusted networkthat can deliver all covered services to ourmembers in a manner that is geographically,culturally, and linguistically appropriate. We havecontracted with Magellan Health Services tomanage behavioral health services for ourCentennial Care members. Magellan HealthServices’ specialized expertise in coordinating a fullcontinuum of behavioral health services will supportdelivery in the most clinically appropriate, leastrestrictivesettings.Presbyterian Behavioral Health ProviderParticipationContracted behavioral health providers arecredentialed to provide services for eligiblemembers enrolled in Presbyterian’s CentennialCare. Although it is the member’s responsibility tounderstand his or her benefit requirements,Presbyterian is available to provide assistance24 hours a day, seven days a week to membersand providers. Please call the behavioral healthcustomer service line at 505-923-5678 for furtherinformation. The Presbyterian Provider Care Unitalso has a dedicated Centennial Care team that isavailable 24 hours a day, seven days a week, 365days a year at 505-923-5757 or 1-800-923-5757.Presbyterian Behavioral Health ProvidersThe behavioral health component of PresbyterianCentennial Care includes a range of providers andorganizations eligible to provide Medicaid services.These include physicians, physician assistants,psychologists, nurse practitioners, social workers,other master’s-prepared therapists, licensedalcohol and drug counselors, Core ServiceAgencies (CSAs), Federally Qualified HealthCenters (FQHCs), hospitals, and tribalorganizations. Presbyterian actively evaluates thecultural diversity of our behavioral health providersand makes every effort to include professionalswho are able to meet the cultural needs of ourmembers. In addition, Presbyterian’s provider9-12014 Practitioner and Provider Manual - Ver. 3