Behavioral Health Services Program
Behavioral health services for Blue Shield Promise Medi-Cal members
Medi-Cal behavioral health coverage through Blue Shield of California Promise Health Plan is available to members in Los Angeles County and San Diego County. Please review the grid below to make the appropriate referrals. We have also provided a training document to inform you about the mental health screening process and transition of care tools.
Mental Health Screening and Transition of Care (PDF, 351 KB)
Behavioral Health Screenings (PDF, 227 KB)
| Referral | Action(s) |
|---|---|
Outpatient treatment for mild to moderate mental health conditions, for all ages:
|
Complete and submit to Blue Shield Promise the Medi-Cal Social Services and Mental Health Referral Form (PDF, 232 KB). The form provides a fax number and an email for submission to Blue Shield Promise. You may also call Social Services at (877) 221-0208. |
Behavioral Health treatment for members under 21 years of age:
|
Call Blue Shield Promise Member Care Coordinators at (888) 297-1325. |
Specialty mental health services for serious mental health conditions:
|
Medi-Cal members can self-refer, and/or providers can offer these resources to their patients so their patients can contact:
Blue Shield Promise is also available to work with the member’s provider to help coordinate the above listed resources on behalf of the member. |
| Substance use disorder services |
|
For more information on the above services, visit their respective pages:
- Mental health
Blue Shield Promise’s responsibility for administering and managing care will be dependent on the Medi-Cal member’s severity of impairment.
- Substance misuse and substance use disorders screening requirements
For screening, assessment, brief intervention, referral, and treatment related (SABIRT) information, please visit the Provider SABIRT page.
- Behavioral Health Treatment for Medi-Cal members under the age of 21
For behavioral health therapy (BHT) related information, please visit our BHT page.
Social Services Support
Blue Shield Promise’s Social Services Department is available to help with the following:
- Removing social determinants that prevent members from receiving the care they need.
- Conducting psychosocial assessments on referrals, connecting members to resources and services based on the patient’s care plan.
- Providing or arranging these services:
- Care coordination
- Crisis intervention
- Discharge planning and transition of care
- Member and family education and advocacy
- Non-emergency medical transportation to medical, dental, mental health and substance use disorder appointments
- Over-the-phone interpretation services
To make a referral, complete the Medi-Cal Social Services and Mental Health Referral Form (PDF, 232 KB) and send it to Blue Shield Promise via email or fax, as directed on the form.
Collaborative coordination of medical and behavioral health care services for your patients
As part of our compliance with the National Committee for Quality Assurance (NCQA) and to ensure alignment with best practices, Blue Shield Promise monitors and encourages strong collaboration in the coordination of care between medical and behavioral health care to encourage continuity.
Blue Shield Promise provides these services:
- Interdisciplinary care team to address a member’s full spectrum of health-related needs across the care continuum
- Comprehensive assessment to identify a member’s needs and barriers to care
- Communication strategy such as rounds, warm handoffs, and connected electronic health records or electronic medical records (EHR/EMR) to support prevention and early intervention
- Robust monitoring system for follow-up care
- Methods to address polypharmacy and indiscriminate use of controlled substances.
- Activities to monitor, evaluate, and improve interventions and quality
Your practice provides these services:
- Obtaining permission from the member to share information with the patient’s primary care physician or other designated healthcare provider(s)
- Response to coordination of care requests
- Follow-up with the member on any outcomes related to shared information
- Treatment plan that best fits the member’s needs
- Collaboration with the member’s care team to share treatment plans
- Confirmation and alignment in medicine prescribed and/or recommended
Behavioral Health Services forms
Use these forms to refer your patients to Blue Shield Promise social services and/or mental health services and treatment programs or request treatment authorizations, when necessary.
Applied Behavioral Analysis Referral Form (PDF, 376 KB)
Medi-Cal Social Services and Mental Health Referral Form (PDF, 232 KB)
Complex Case Management
Our Complex Case Management program allows us to work directly with members and collaborate closely with their physicians to coordinate care and services to high-risk members.
Alcohol and drug screening and services
Learn about the alcohol and drug screening, assessment, brief interventions and referral to treatment (SABIRT) program for Medi-Cal members 11 years of age and older, including pregnant women.
Behavioral health treatment for Medi-Cal members under the age of 21
Learn about Blue Shield Promise Medi-Cal benefits, eligibility requirements, and referral procedures.
Find a provider
Use our online tool to find a primary care physician, behavioral health services, and other providers.
Population Health Management
Our Disease Management Program provides education, care coordination, and support for members with certain chronic conditions.
Adverse Childhood Experiences (ACEs) Screening Initiative
Blue Shield Promise is furthering the statewide effort to reduce Adverse Childhood Experiences (ACEs) and toxic stress by half in one generation, and to ensure providers are ACEs Aware.
Depression screening
Access tools for member depression screenings, which are required annually.
Maternal Mental Health and Pregnancy Loss Programs
Learn about mental health resources for network practitioners who are providing prenatal or postpartum care.
Annual cognitive health assessments
Medi-Cal members aged 65 years and older should receive a cognitive health assessment each year if they are ineligible to receive one through Medicare.