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Follow-Up Visit Within Seven Days Following Inpatient Mental Health Stays

Blue Cross and Blue Shield of North Carolina (BCBSNC) would like to remind you of the importance of ensuring that our members receive timely ambulatory follow-up appointments within seven days of discharge after mental health-related hospitalizations from an acute-care setting.

BCBSNC delegates the administration of mental health services and substance abuse management (including certification, concurrent review, discharge planning, and case management) to Magellan Health Services.

Tips to Ensure Successful Follow-Up Care After Hospitalization

  • Magellan can provide you with a list of outpatient behavioral health network providers or psychiatrists, and they will assist you with any scheduling challenges before the member is discharged, if needed (1-800-344-1255).
  • Schedule a follow-up appointment with a behavioral health provider (not primary care physician) before the member is discharged from the hospital.
  • A member should not be discharged with instructions to set up his or her own follow-up appointment.
  • Explain the benefits of aftercare to the member, so he or she understands the importance of keeping the follow-up appointment(s).
  • Confirm with the member that the aftercare plan works for him or her—does the time of the appointment work with their schedule, does the patient have transportation, etc.
  • Involve and educate the member’s family to support the aftercare plan.
  • Explain to the member the importance of staying on medication and notifying the prescribing physician of any side effects.

Important Billing Information: Please remember to submit all claims to BCBSNC as soon as possible. This enables us to reconcile with the National Committee for Quality Assurance (NCQA) and other entities for timely reporting. Following is a list of the acceptable billing codes to use for follow-up visits after hospitalization:

98960-98962, 99078, 99201-99205, 99211-99215, 99217-99220, 99241-99245, 99341-99345, 99347-99350, 99383-99387, 99393-99397, 99401-99404, 99411, 99412, 99510, 90845, 90847, 90849, 90853, 90870, 90875, 90876, 99221-99223, 99231-99233, 99238, 99239, 99251-99255, 90791, 90792, 90832, 90834, 90837, 99304, 99324, 90839

For more details about this integral component of aftercare compliance, please see the article on this topic from October 2013. If you have any questions, please call the Provider Blue LineSM at 1.800.214.4844.