Clinical Connections – Optum Transition Details + more!
Dear Colleagues,
We are pleased to share details of our transition to Optum Behavioral Health, effective Jan. 1, 2023. This change to Optum providers applies to all WHA members. We’ve communicated with our members on how to transition care with details on the member webpage, mywha.org/bh.
This move to Optum provides WHA members with a large network of behavioral health providers (both in-person and virtual), as well as expanded behavioral health inpatient facilities. Members will also enjoy an enhanced digital portal and tools through the Liveandworkwell.com website, which is an excellent resource for patients to screen their symptoms, get triaged to the most suitable care, and search for mental health professionals.
WHA members may need help transitioning to Optum providers and systematic efforts are underway to minimize disruptions. Below are important links to note for referrals and information related to this transition:
- WHA members can find the Optum provider directory and information and how to transition their current behavioral health care to Optum, on the member webpage, mywha.org/bh.
- After January 1, 2023, your WHA patients can call Optum directly for help choosing an in-network provider: Group and Individual members call: 800.765.6820; MyCare Medicare Advantage members, may call: 855.857.9748
- PCPs and behavioral health providers can use providerexpress.com to access behavioral toolkits
- For prescribers of Spravato, please refer to the Optum FAQs for WHA (linked here)
- For service and claims submissions, please refer to the back of the WHA member’s ID card
- Clinical providers can refer patents for behavioral health care coordination – see an overview here
- Your medical group care coordination teams should have access to Optum’s care coordination platform for specialized behavioral health case management referral
- Non-contracted Providers may also contact Optum BH at 877-614-0484 to see if they’d like to become contracted at Optum Network Services. If you are seeing WHA member/patient, please call to ensure you have information on a transition of care and/or claims processing.
By consolidating our mental health services from Optum Behavioral Health, with retail pharmacy services through OptumRx, and existing Optum Disease Management programs, our members will realize real synergies across the continuum of care.
In addition, please read on for other news, including a makeover on our WHA logo to share with your front office staff, as they will see those new cards, starting Jan. 1, 2023.
Khuram Arif M.D., MBA, CPE
Chief Medical Officer,
Chief Operating Officer,
Western Health Advantage
Share with Your Staff: New Logo WHA ID Cards
Your front office staff will see a new WHA logo on our member ID cards for 2023. Not only do the cards sport this new logo, but they will also confirm the medical group of the member’s PCP and the plan’s deductible and out-of-pocket maximum amounts. On the backside, the cards will list Optum’s NurseLine and Behavioral Health phone numbers.
PHARMACY UPDATE
Checking Scripts During Transition from Magellan to Optum
WHA continues to support our behavioral health services to our members, and during this transition to Optum, it’s a good time to remind your patients to continue taking their medications on time, as prescribed. Additionally, while we anticipate a seamless transition for our members, those transitioning to a new provider will need to have an ample supply of their medications on hand. Since our PBM is not changing, we do not anticipate challenges with our pharmacy but, we do not want our members going without key medications.
Save Money on Insulin and Vaccines
The Inflation Reduction Act is new this year, but the good news is WHA will continue to participate in the Insulin Senior Savings Model, with insulin products on our formulary available to members for $35 dollars or less. We will also continue to provide access to $0 vaccines. Please encourage our members to take advantage of these wonderful programs.