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Providers

Behavioral health tools and programs for providers

   

Collaborating on health improvement

Behavioral health concerns are on the rise. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is working with providers to improve how and when behavioral health concerns are identified and treated. Together, we can help the whole person thrive by bringing physical and behavioral health together.

Take a look at some of our programs you can participate in, and learn about new tools and resources you can use in your practice. We look forward to working with you and supporting your continued efforts to improve health outcomes for your patients.

Behavioral health

Close to 70% of behavioral health patients have a medical co-morbidity.1

Behavioral Health Total Care

Behavioral Health Total Care addresses the complex health needs of members with serious mental illness, substance use disorder, or both conditions. This program is available to eligible members with Commercial, Federal Employee Program (FEP), and Medicare Advantage plans. This program encourages members to participate with our Blue Cross NC Behavioral Health Care Management team to:

  • Assist members in understanding their condition
  • Ensure members are actively engaged with behavioral health provider(s) as needed
  • Help address any social determinants of health that may impede their ability to address their mental health care needs

These services are designed to reduce hospital admissions, as well as improve members’ overall health and quality of life. Effective August 1, this program will be available in all of North Carolina.

Primary care settings are a “gateway” for many individuals with behavioral health care needs.

Behavioral Health On Demand

Blue Cross NC is now offering Behavioral Health On Demand (BHOD), a virtual urgent care alternative for members who would otherwise visit the emergency department for urgent behavioral health needs. BHOD will serve as a same-day access point for care and provide a safety net for those who require assistance.

Eligible members can access these services online or by phone:

The member will be connected with an On Demand specialist who will help them complete the required forms and assessments. Then the specialist will add the member to the queue to visit a provider.

The specialist will schedule a same-day appointment with an On Demand provider when available. The provider will perform a clinical assessment and may treat the member with one of the following services:

  • Medication management
  • Therapy
  • De-escalation (if / when necessary)
  • Pediatric mental health care
  • Family / marital counseling
  • Attention-deficit / hyperactivity disorder (ADHD) evaluation

If needed, the provider will transition members to outpatient services in their broader health care system.

As with all services and programs, members should check their benefit information to confirm eligibility. Members 6 years of age and older can be treated through BHOD.

In case of emergency, you can advise members to:

  • Call the mental health number on the back of their Blue Cross NC member ID card and select the option for “Crisis”
  • Call 988 (the Suicide and Crisis Lifeline)
  • Call 911
  • Or go to the nearest emergency department in the event of a psychiatric or medical emergency

Behavioral Health Care Navigation services

Blue Cross NC has Behavioral Health Care Navigation services to make it easier to identify and address behavioral health disorders earlier and more effectively. This allows for better integration of physical and behavioral health care. It's an important part of our long-term strategy to help deliver quality care, increase long-term savings and improve patient experience.

Our Care Navigators will aid primary care providers to connect their patients to the right behavioral health professionals. To complete a referral request for your patient, fill out our Behavioral Health Referral Form.

Based on the information provided, the Care Navigators will identify a behavioral health provider who can treat your patient. The Care Navigator will also reach out to the member to help schedule their appointment and follow up to see if the appointment was held.

Blue Distinction Centers

For substance use treatment and recovery

Blue Distinction is a national designation given by Blue Cross Blue Shield (BCBS) companies to recognize providers that demonstrate expertise in delivering quality specialty care – safely, effectively and cost-efficiently.

The goal of the program is to help consumers find both higher quality and more affordable health care for their specialty care needs, while providing a credible foundation on which employers may customize their employee benefits.

Providers who offer or help to support treatment for substance use disorders, including opioid use disorder, can qualify for the Blue Distinction Centers for Substance Use Treatment and Recovery specialty.

Go to the Blue Cross Blue Shield Association site to download:

  • A list of Blue Distinction Centers
  • Selection criteria
  • Designation materials

Questions?