Common use of CO-OCCURRING TREATMENT AND NO WRONG DOOR Clause in Contracts

CO-OCCURRING TREATMENT AND NO WRONG DOOR. 2.6.1. Per BHIN 22-011, Specialty and Non-Specialty Mental Health Services can be provided concurrently, if those services are clinically appropriate, coordinated, and not duplicative. When a member meets criteria for both NSMHS and SMHS, the member should receive services based on individual clinical need and established therapeutic relationships. Clinically appropriate and covered SMHS can also be provided when the member has a co-occurring mental health condition and substance use disorder. 2.6.2. Under this Agreement, CONTRACTOR will ensure that members receive timely mental health services without delay. Services are reimbursable to CONTRACTOR by COUNTY even when: 2.6.2.1. Services are provided prior to determination of a diagnosis, during the assessment or prior to determination of whether SMHS access criteria are met, even if the assessment ultimately indicates the member does not meet criteria for SMHS. 2.6.2.2. If CONTRACTOR is serving a member receiving both SMHS and NSMHS, CONTRACTOR holds responsibility for documenting coordination of care and ensuring that services are non-duplicative.