CoCM is a model of behavioral health integration that enhances normal primary care by adding care management support for patients receiving behavioral health treatment and regular psychiatric inter-specialty consultation to the primary care team, particularly patients whose conditions are not improving.
Care Team Involved
Primary care physician and a care manager who work in collaboration with a psychiatric consultant, such as a psychiatrist.
Psychiatric Consultant (Powered by Certintell)
Behavioral Health Peer Advocate
70 minutes or more of initial psychiatric CoCM services, 60 minutes or more of subsequent psychiatric CoCM services
As required by CMS, our solution goes beyond telephonic to cover all of your CCM needs; including asynchronous secure messaging, video calls, and Remote Patient Monitoring (RPM)
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Primary care practitioner will direct the behavioral health care manager or clinical staff and oversee all of the beneficiary’s care, including the ongoing oversight, management, collaboration and reassessment.
Care is directed by the primary care team and includes structured care management with regular assessments of clinical status using validated tools and modification of treatment as appropriate.
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Behavioral Health Care Manager provide assessment and care management services, including the execution of validated rating scales and behavioral health care planning in relation to behavioral/psychiatric health problems; ongoing collaboration with the FQHC practitioner; maintenance of the registry; acting in consultation with the psychiatric consultant; and be available to provide services face-to face with the beneficiary; having a continuous relationship with the patient and a collaborative, integrated relationship with the rest of the care team.
Psychiatric Consultant will participate in regular reviews of the clinical status of patients receiving CoCM services, advise the practitioner regarding diagnosis, make adjustments to behavioral health treatment for beneficiaries who are not progressing and facilitate referral for direct provision of psychiatric care when clinically indicated.