Care Management is a voluntary, confidential, and no-cost benefit that supports Select Health members with complex care needs through provider and caregiver coordination, benefit navigation, and connection to internal programs and community resources. Behavioral health providers should consider a Care Management referral when a member's needs extend beyond behavioral health treatment alone, and additional support may be needed to address medical, social, functional, or care coordination barriers.
When should behavioral health providers refer to Care Management?
Common referral indicators include:
- Complex behavioral health needs: Serious mental illness, complex behavioral health conditions, or co-occurring medical and behavioral health diagnoses.
- Repeated hospitalizations or crisis-related needs: Repeated psychiatric hospitalizations, emergency department visits, behavioral health crises, or transitions from inpatient, residential, or emergency behavioral health services.
- Treatment engagement barriers: Difficulty engaging in treatment, medication adherence, or follow-up care.
- Functional or safety concerns: Significant impairment affecting daily living, employment, school, or relationships, or concerns about member safety and stability.
- Social determinants: Housing instability, food insecurity, transportation barriers, or other social needs affecting health and access to care.
- Care coordination needs: Coordination among behavioral health, medical, specialty, school, community, or social service providers.
- Specialized support needs: Pregnancy, high-risk maternal health concerns, pediatric complex needs, or dual Medicare/Medicaid eligibility.
Rule of thumb: If factors outside the therapy room or medication visit are creating barriers to a member's health, recovery, stability, or access to care, a Care Management referral may be appropriate.
How do I refer a member to Care Management?
If you have a member you think would benefit from the help of the Care Management team, fill out this form and a care manager will reach out within 7 business days.
REFERENCES
U.S. Department of Health and Human Services. “Under HIPAA, May a Health Care Provider Disclose Information Requested by a 3rd Party for Treatment Purposes?” HHS.gov. Accessed September 9, 2026. https://www.hhs.gov/hipaa/for-professionals/faq/512/under-hipaa-may-a-health-care-provider-disclose-information-requested-for-treatment/index.html.