| site map | privacy statement | contact us | home | ||
 |
 |
|
|
About Beacon and Neighborhood Beacon Health Strategies (Beacon) is the behavioral health partner of Neighborhood Health Plan of Rhode Island (Neighborhood). Founded in 1996, Beacon serves over 1.4 million members, affording them a variety of health and case management services, tailored to meet their individual needs.
This "tool kit" has been assembled to give our providers a one-stop resource to information about how and where to get behavioral health help for Neighborhood members. Behavioral Health Benefit Information All Neighborhood members receive an initial twelve (12) outpatient therapy visits (Initial Encounters) to one behavioral health provider per calendar year, which do not require prior authorization but are subject to meeting medical necessity. A Primary Care Physician referral is NOT required in accessing behavioral health services Members have access to a variety of mental health and substance abuse levels of care that are subject to medical necessity criteria including, but not limited to, Intensive Outpatient, Day Treatment, Partial Hospitalization, Crisis Stabilization Services, and Inpatient Treatment.
Beacon Member Services Clinical Referral Line: 1-800-215-0058 The Beacon Member Services line can be used for a variety of reasons: • Self refer to a contracted provider identified via Beacon’s web site, beaconhealthstrategies.com • Contact Beacon Health Strategies directly at 1-800-215-0058 for a referral to contracted providers. Primary Care Providers Can: • Call Beacon at 1-800-215-0058 and press option # 3 or visit Beacon’s web site beaconhealthstrategies.com, for the names of contracted Neighborhood providers.• Locate a contracted provider • If a member needs an urgent appointment or has had difficulty in scheduling a routine appointment, contact this number to request assistance. Case Management Substance Abuse Information • Programs for Members with Alcohol and Substance Abuse
Postpartum Depression Resources • Flyer • Neighborhood's Bright Start program Antidepressant Medication Management HEDIS® Antidepressant Medication Management Measure* • Patients 18 years and older that have a new episode of depression and were prescribed an antidepressant medication, and remain on antidepressant medication during the entire 12-week acute phase. (Effective Acute Phase Treatment*) • Patients 18 years and older that have a new episode of depression and remain on antidepressant medication for at least 6 months (Effective Continuation Phase Treatment*) • 2010 HEDIS ICD-9-CM Diagnosis codes for Major Depression: 296.20-296.25 *Our goal for AMM is to be within the 75th percentile for both courses of treatment. • Diagnosis guidelines for Depression ADHD HEDIS Follow-Up Care for Children Prescribed ADHD Medication (ADD) • Children (6-12 years) newly prescribed attention-deficity/hyperactivity disorder (ADHD) medication who have had one follow-up visit with a practitioner with prescribing authority within 30 days of the prescription dispense date. (Initiation Phase*) • Children who remained on their medication for at least 210 days and who had at least an additional two follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase has ended. (Continuation & Maintenance Phase*) *Our goal is to be within the 90th percentile for all phases.
|
|
|||
|
|
All PDFs require the free © Neighborhood Health Plan of Rhode Island. All Rights Reserved. |