AdministrativeAnthem Blue Cross and Blue Shield | CommercialDecember 1, 2024

Coordination of care

Coordination of care among providers is vital to good treatment planning and ensures appropriate diagnosis, treatment, and referral. We want to take this opportunity to stress the importance of communicating with your patients’ other healthcare practitioners, including PCPs/PMPs, medical specialists, and behavioral health practitioners.

Coordination of care is essential for patients who use general medical services extensively and those referred to a behavioral health specialist by another healthcare practitioner. We urge all our practitioners to obtain the appropriate permission from these patients to coordinate care between behavioral health and other healthcare practitioners when treatment begins.

We expect all healthcare practitioners to:

  1. Discuss with the patient the importance of communicating with other treating practitioners.
  2. Obtain a signed release from the patient and file a copy in the medical record.
  3. Document in the medical record if the patient refuses to sign a release.
  4. Document in the medical record if you request a consultation.
  5. If you make a referral, transmit the necessary information; if you furnish a referral, report appropriate information to the referring practitioner.
  6. Document evidence of clinical feedback (for example, a consultation report) that includes, but is not limited to:
    • Diagnosis
    • Treatment plan
    • Referrals
    • Psychopharmacological medication (as applicable)

To facilitate coordination of care, we have several tools available at https://www.Anthem.com/provider/forms/ for behavioral health and other medical practitioners, including:

  • Coordination of Care Form
  • Coordination of Care Letter Template — Behavioral Health
  • Coordination of Care Letter Template — Medical
  • Resources for provider collaboration and integrated care, including Practice Guidelines, assessment tools, suicide awareness, and multicultural education and guidance

The following behavioral health forms, brochures, and screening tools for substance use disorder and attention‑deficit/hyperactivity disorder (ADHD) are also available at https://www.Anthem.com/provider/forms/:

  • Alcohol use assessment brochure
  • Antidepressant medication management
  • Edinburgh Postnatal Depression Scale
  • Opioid use assessment brochure
  • Substance Brief Intervention/Referral Tool (SBIRT)
  • Vanderbilt ADHD Diagnostic Parent Rating Scale

We are committed to finding solutions that help our care provider partners offer quality services to our members.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Maine, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BCBS-CM-072071-24-CPN70343

PUBLICATIONS: December 2024 Provider Newsletter