Your responsibilities as a provider
If you are a Behavioral Health Provider in an Integrated Managed Care (IMC) region, you’re responsible for conducting an initial assessment for first-time patients to assess their level of need, coordinating with your patient’s primary care provider, and securing an appointment with an appropriate behavioral health provider by either calling CHPW to coordinate care or securing the appointment yourself.
If you are a Behavioral Health Provider in a non-IMC region, you are responsible for conducting an initial assessment to determine treatment needs and whether they meet Washington’s Access to Care Standards, and securing a follow-up appointment with an appropriate behavioral health provider, which you can do by calling CHPW to coordinate care.
If you are a primary care provider, you are responsible for coordinating with your patient’s behavioral health provider. You do not need to submit a referral for your patient’s mental health or substance use treatment. If you need help finding an appropriate behavioral health provider for your patient, please call CHPW, or direct your patient to call on their own behalf.
Your patient does not need a referral to see a behavioral health provider.
CHPW is your single point of contact and will ensure access to care
Providers seeking mental health treatment for their CHPW patients are no longer burdened with making multiple calls.
CHPW has a new Customer Service process to take on the responsibility of ensuring access to an appropriate mental health provider for children seeking treatment.
This policy comes in response to state legislation (RCW 74.09.340) requiring all managed care organizations to “ensure that children with mental health needs secure an appointment with an appropriate Mental Health Provider.”
The new CHPW process is designed to reduce challenges faced by parents, caregivers and youth calling multiple providers looking for mental health providers to find those taking new patients. Since providers often help patients access specialty services, including behavioral health, we want to let providers know about the new process for members to call Community Health Plan of Washington customer service for children’s mental health. Parents, caregivers or youth seeking mental health services can receive help by asking customer services for help in accessing mental health services for patients up to age 20. The call to customer service will trigger a connection to training care management staff that will identify available mental health and substance use providers in the area until we secure an appointment for your patient.
We will also work with you to find appropriate services for your adult patients.