Coordination of Care and Health Status Change

It is very important that PCPs develop a strong communication link with a member’s behavioral health provider. PCPs are expected to exchange any relevant information such as medical history, current medications, diagnosis and treatment within 10 business days of receiving the request from the behavioral health provider.

Where there has been a change in a member’s health status identified by a medical provider, there should be coordination of care with the behavioral health provider within a timely manner. The update should include but is not limited to; diagnosis of chronic conditions, support for the petitioning process, and all medication prescribed.

The PCP should also document and initial signifying review receipt of information received from a behavioral health provider who is treating the member. All efforts to coordinate on care on behalf of the member should be documented in the member’s medical record.

The RBHA will provide the PCP with a one-time consultation regarding behavioral health treatment options, medications, referrals, and transition of care. PCPs should call the RBHA directly to request a consultation.

When a member’s mental health status renders them incapable or unwilling to manage their medical condition and the member has a skilled medical need, Mercy Care Plan will arrange ongoing medically necessary nursing services in collaboration with the member’s PCP.

4350 E. Cotton Center Blvd.,
Bldg D, Phoenix,
Arizona 85040
Member Services
7 a.m. to 6 p.m. Monday-Friday
602-263-3000,
Toll-free 1-800-624-3879
(TTY/TDD)
Toll-free: 1-866-602-1982

If you or a family member has a medical emergency, dial 911.