MDwise

Below are tools for handling behavioral health issues with MDwise members, useful for both physical and behavioral health providers. These tools have been developed based upon the needs of our members and for ease of use in busy provider offices.
 

Integrated Care

MDwise has collected information from multiple websites that contain information on how other health systems and states are implementing integrated health care formats.
 

Behavioral Health Benefits Program Guides

• Applied Behavioral Analysis Provider Program Guide​
• Opioid Treatment Provider Program Guide​

Behavioral Health Quality Resources

MDwise cares about the quality of services our members are getting. We have several resources available to help you understand some of the quality standards we measure.

• 2020 HEDIS Poster
  • MDwise cares about our members and the quality of care they receive, and we want to help you do everything you can to deliver the best care and provide a positive experience for your patient. You can use this quick guide to help you better understand, document, and code the HEDIS measures pertaining to Behavioral Health. Please contact the MDwise Behavioral Health Specialist with questions or if you need more information.
• 2017 BH P40
• 2018 BH P4O
• Behavioral Health Standards for Accessibility
  • NCQA measures standards of accessibility of behavioral health appointments. Members should expect appointment times within these time frames.
• HEDIS Follow Up After Emergency Department Visit for Alcohol or Other Drug Abuse or Dependence (FUA) and Follow Up After Emergency Department Visit for Mental Illness (FUM)
  • HEDIS measures the percentage of members 13 years of age and older that had an emergency department visit with principal diagnosis of alcohol or other drug abuse/dependence (FUA) or 6 years of age and older with diagnosis of mental illness (FUM) and had a follow-up appointment with any practitioner (within 7 days of discharge and within 30 days of being seen in the emergency department). 
• HEDIS Follow Up After Hospitalization for Mental Illness (FUH)
  • When a member has been admitted to an inpatient hospital, it is important they have a follow up appointment within 7 days of being discharged. HEDIS measures if a member attended their appointment.
• HEDIS Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)
  • HEDIS measures the percentage of children and adolescents 1–17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first-line treatment within 90 days of the medication start date.
• HEDIS Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)
  • HEDIS measures the percentage of children and adolescents ages 1-17 years of age who had two or more antipsychotic prescriptions and had metabolic testing.

Behavioral Health Provider Resources

• Social Determinants of Health Graphic
• Patient Health Questionnaire-2 (PHQ-2)
• Behavioral Health Toolkit for Primary Medical Providers (PMPs)
• When to Refer to a Behavioral Health Provider Guide
• MDwise Behavioral Health Poster
• Behavioral Health Going Home Guide
• Evaluation and Management Services Guide
• Using Telemedicine to Integrate Behavioral Health Care Brochure
• Find a Behavioral Health Provider
• Rating Scale Resources
  • Vanderbilt ADHD Rating Scale
  • Pediatric Symptoms Checklist
  • For Care Managers, PHQ9 Depression Screening
• SMART Goals: How to use rating scales for goal writing
• MDwise Outpatient Treatment Request (OTR) Guide: Provides instructions on the vital information to include on the OTR form in order to receive prior authorization

 

Forms

• Behavioral Health Forms
• Provider Contract Inquiry

 

Behavioral Health Member Resources

Alcohol Substance Use Information
Chronic Pain
Drug Substance Use Information
Opiate Addiction
 

Behavioral Health Clinical Practice Guidelines

Attention Deficit Hyperactivity Disorder
Anxiety Disorders in Children and Adults
Autism Spectrum Disorder
Bipolar Disorder in Adults
Chronic Muscular/Skeletal Pain
Depression in Adults
Depression in Children and Adolescents
Developmental Testing
Eating Disorders
Metabolic Status
Neuropsychological Testing
Postpartum Mood Disturbance
Psychological Testing
PTSD in Adolescents and Children
PTSD in Adults
Schizophrenia
Substance Use Disorders in Adults