CARE MANAGEMENT/ COORDINATION OF CARE a. The LME/PIHP shall ensure the coordination of care with each Enrollee’s primary care provider and any behavioral health provider enrolled to provide care for each Enrollee. LME/PIHP shall coordinate the discharge of Enrollees with CONTRACTOR to ensure that appropriate services have been arranged following discharge and to link Enrollee with other providers or community assistance.
b. The LME/PIHP shall provide coordination of care to high risk Enrollees discharged from twenty-four hour care.
c. If an Enrollee requires medically necessary MH/DD/SA services, the LME/PIHP shall arrange for Medicaid-reimbursable services for the Enrollee when possible.
CARE MANAGEMENT/ COORDINATION OF CARE. 3.6.1. Sandhills Center shall ensure the coordination of care with each Member’s primary care provider and any behavioral health provider enrolled to provide care for each Member. Sandhills Center shall coordinate the discharge of Members with Provider to ensure that appropriate services have been arranged following discharge and to link Member with other providers or community assistance.
3.6.2. Sandhills Center shall provide coordination of care to high-risk Members discharged from twenty-four hour care.
3.6.3. If an Member requires medically necessary MH/DD/SA services, Sandhills Center shall arrange for Medicaid-reimbursable services for the Member when possible.
CARE MANAGEMENT/ COORDINATION OF CARE a. Where services are provided by other entities, the LME/PIHP shall ensure the coordination of care with each Enrollees’ primary care provider and any behavioral health provider enrolled to provide care for each Enrollee. LME/PIHP shall coordinate the discharge of Enrollees with LIP to ensure that appropriate services have been arranged following discharge and to link Enrollee with other providers or community assistance. The LIP will make best efforts to collaborate with LME/PIHP Care Management/Care Coordination, primary care physicians and other services providers.
b. If an Enrollee requires medically necessary MH/DD/SA services, the LME/PIHP shall arrange for Medicaid-reimbursable services for the Enrollee.
CARE MANAGEMENT/ COORDINATION OF CARE. A. The BH I/DD Tailored Plan shall ensure the coordination of care with each Member’s primary care provider and any behavioral health provider enrolled to provide care for each Member. The BH I/DD Tailored Plan shall coordinate the discharge of Members with Contractor to ensure that appropriate services have been arranged following discharge and to link Members with other providers or community assistance.
B. The BH I/DD Tailored Plan shall provide coordination of care to high risk Members discharged from twenty-four hour care as set forth in BH I/DD Tailored Plan’s contracts with the Department.
C. If a Member requires medically necessary MH/IDD/SA services, the BH I/DD Tailored Plan shall arrange for Medicaid reimbursable services for the Member when possible.
CARE MANAGEMENT/ COORDINATION OF CARE. The LME/PIHP shall ensure the coordination of care with each Enrollee’s primary care provider and any behavioral health provider enrolled to provide care for each Enrollee. LME/PIHP shall coordinate the discharge of Enrollees with CONTRACTOR to ensure that appropriate services have been arranged following discharge and to link Enrollee with other providers or community assistance.
