Coordination of Care

Here is information I received from Cigna. Many insurance companies are encouraging Coordination of Care, which in my opinion is a more holistic and integrative approach to patient care.

We understand the complex relationship between the emotional and physical factors related to behavioral health, as psychiatric symptoms may be present that complicate medical illnesses.

Alternatively, medical illnesses may also be identified via psychiatric symptoms. That’s why clear communication must exist among a patient’s treating practitioners and primary care physician (PCP). This coordination of care between behavioral health and general medical care is imperative to a patient’s effective treatment.

We recommend that the following steps be taken at the beginning of treatment to help ensure you have access to the clinical information you need to thoroughly assess the patient’s condition:

• Have the patient sign a “Release of Information” form.
• Collect all information from the patient’s PCP and other practitioners who provide care to the patient.

With this consent, the appropriate clinical information can be exchanged directly with the PCP throughout the patient’s treatment, while facilities can notify the PCP upon admission and discharge. Communication with the PCP should occur:

• After the initial assessment, and should include diagnosis, medication, initial treatment plan, and any recommended or ordered diagnostic tests.
• When the patient does not comply with treatment recommendations.
• When patient’s level of care or condition has significantly changed.
• When behavioral treatment has been completed.

All communication with the PCP and other practitioners should be documented and presented to CIGNA Care Managers as clinical updates are needed.

Please note that compliance with coordinating behavioral care is monitored through care management and medical record reviews.

Additional Information

For more information on Coordination of Care, please access the Medical Management Program (Section 5, Pages 29-30).

We also provide clinical screening tools as a resource to aid in the coordination of care with PCPs. These documents, including consent forms and a sample of structured communications, can be found in Appendix G of the Medical Management Program.

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