Coordinating care for medical and behavioral health

Immediately: Billing and clinical teams should identify shared medical/behavioral health patients in the practice. Obtain signed Authorization to Disclose Protected Health Information forms (Harvard Pilgrim Health Care or Tufts Health Plan versions) from these patients to enable provider communication. Implement use of Point32Health's Coordination of Care Checklist (or develop equivalent documentation system) to track and exchange provider contacts, progress notes, diagnoses, and medications among care team members. For Harvard Pilgrim Health Care and Tufts Health Plan Commercial members eligible for BHI services, review the CMS MLN Booklet on Behavioral Health Integration Services and associated billing FAQs to ensure proper coding and documentation. Contact Harvard Pilgrim Health Care at 800-708-4414 or relevant Tufts Health Plan provider line with questions. Failure to coordinate care and obtain proper authorizations may result in fragmented treatment plans and potential claim denials if BHI services are not properly billed when eligible.