Behavioral Health FAQs

December 30, 2021

Effective March 2022

 

To view as a pdf, please click here.

To  go to the Premier Behavioral Health’s website. please go here: http://premierbehavioralhealthcare.com

 

High Desert Medical Group (HDMG) Behavioral Health Services FAQ

What has changed regarding access to Behavioral Health Services for HDMG?
The changes in Behavioral Health Services for HDMG members affects only those Medicare Advantage members previously serviced by Windstone Behavioral Health. All other Behavioral Health Services for HDMG members remain unchanged.
Effective March 1, 2022, the capitated agreement with Windstone Behavioral Health has been terminated with High Desert Medical Group. Most Psychiatrists and Therapists previously available thru the Windstone contract are now being made available through direct contracts with HDMG. Our Primary Care or any referring physicians can choose any eligible Behavioral Health provider that is convenient for the member. They will also have the option of choosing HDMG Behavioral Health as a specialty option. If this option is chosen, the member will receive an authorization letter with the HDMG BH contact number 833-409-2471. When the member calls, the behavioral team will provide them a specific behavioralist and assist with the authorization.

For Psychiatry services, the provider can request a 90792 – Psychiatric diagnostic evaluation with medical services.

For Therapy services, the provider can request a 90791 – Psychiatric diagnostic evaluation without medical services.

If any questions arise, the Behavioral Health team can be contacted during regular business hours at 833-409-2471. Please remember, these are for HDMG Medicare Advantage members for whom we have Behavioral Health risk.

 

What Health Plans or Lines of Business does this affect?
HDMG has Behavioral Health risk for all Medicare Advantage (MA) members except:
• Health Net – patients may call MHN 888-426-0030.
• LA Care – patients may call Beacon 877-344-2858
• Molina – patients may call Molina 888-665-4621

 

How do we access services given the change?
1) Our Primary Care or any referring physicians can choose any eligible Behavioral Health provider that is convenient for the member. The referrals will be processed by our Behavioral Health team. Should a Behavioralist not be accepting new members, we will call the referring PCP and the member and assist with choosing an alternative provider .
a. You also have access to a BH provider entitled “HDMG Behavioral Health”. When chosen, the member will receive an authorization letter with the HDMG BH contact number 1-833-409-2471 with the authorization.
2) Our Primary Care or any referring physician that may not have access to Q can always fax a standard referral form to 714-908-7256
3) A member can self-refer by calling 1-833-409-2471. The physicians have been given referral cards to provide to members
4) Physicians, Case managers and coordinators can always e mail referrals to the team at bhc-group@premierbhc.com and an outreach will be made to the members

If any questions arise, the Behavioral Health team can be contacted during regular business hours at 1-833-409-2471. Please remember, these are for HDMG Medicare Advantage members for whom we have Behavioral Health risk.

 

Do Behavioral Health services require a PCP referral and authorization?
Members always have the ability to self-refer, but we prefer our primary care physicians and/or specialists to put in a referral and obtain an authorization. This allows us to account for member compliance rates.

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