Medical Mutual facilitates continuity and coordination of medical and behavioral health care services as members transition across settings and between practitioners. Our initiatives help ensure members can access the care and services they need. The Continuity of Care Guidelines support providers in getting the information they need to deliver the best care possible.

Referring Provider

Before a consultation takes place, share all necessary clinical information, including the following:

  • Reason for the consultation
  • Pertinent clinical information
  • Preferred method(s) of communication from the consultant (e.g., fax, phone, mail, email)

Consulting Provider

Medical/Surgical

A written summary of the consultation and findings should be sent to the referring provider as expeditiously as condition warrants after the initial visit. Any preliminary report should be followed by a final report.

Behavioral Health

The behavioral health consultant is responsible for obtaining a signed consent from the covered person permitting the communication of important clinical information to the referring provider. If the covered person consents to communication, the behavioral health consultant is responsible for exchanging information regarding the covered person’s evaluation and care plan to the referring physician. The communication should be completed as expeditiously as condition warrants after the initial evaluation.

Communication Components

The communication should contain the following components when applicable:

  • Clinical Evaluation – Pertinent information from your evaluation
  • Diagnostic Tests – Results of completed tests and recommendations for additional testing
  • Clinical Impression – Patient’s diagnosis and/or differential diagnosis
  • Medication Therapy – Current medication list with new medications added and any medication adherence issues
  • Treatment Plan – Therapy rendered and ongoing recommendations
  • Follow-up – Recommendations concerning who should provide follow-up care and when those services should be performed

The company maintains strict privacy and confidentiality policies aimed at ensuring that covered persons are treated in a manner that respects their rights and protects the confidentiality of personal health information and records.