REFFERAL PROCESS

It should be considered an indication for psychological assessment when a Resident exhibits any of the following:

• A mental health diagnosis on the face sheet.
• On psychotropic medications.
• Triggers in “Section - E” of the MDS.
• Exhibits behavior problems.
• The Resident/Family or Conservator expresses concerns.
• Nursing / Social Service / Physical Therapy / Activities Department(s) expresses concerns.
• An observation by the GCI psychologist that a Resident is in need of interventions.
• Resident Care Plan(s) e.g., Depression, Anxiety, Behavioral Issues, Adjustment, Failure to Thrive, etc.
• Referral by the primary care physician or the psychiatrist.

DO NOT OBTAIN THE PHYSICIANS ORDER UNTIL AFTER INSURANCE COVERAGE HAS BEEN VERIFIED BY GCI.

STEP 1 .

Insurance Verification:   Performed by facility Social Service Director or other staff member.

Fax the Resident’s Face Sheet and the completed and signed Referral Form, (GCI Form A-9) to (619) 466-2662.

Geriatric Counseling, Inc., will attempt to verify insurance coverage and contact the facility staff member who requested the initial assessment to initiate the next step in our referral process.  GCI will also notify our psychologist of the referral at this time if the Resident has valid insurance coverage.  Please call the office of Geriatric Counseling, Inc. to request forms or ask for assistance. (800) 424-2686.

We accept the following types of insurance:

A. Medicare “Part B” (even if the Resident is in the facility under a Medicare “Part A” stay).

B. Medi-Medi (Medicare primary and Medi-Cal secondary).

C. Private Pay / Self Pay (Cash “Consent for Treatment” GCI Form A-7.CSH required). Any Resident who is a member of an HMO or private pay may elect to have the services if they sign a self pay “Consent for Treatment” “(Form A7.CSH)” and elect to pay for services “Out of Pocket”.

D. Hospice.

We do not obtain authorizations from HMO’s.

STEP 2 .

”Physicians Orders” & “Consent for Treatment”:   Performed by facility Social Service Director or other staff member.

Facility staff must obtain “Consent for Treatment” utilizing (GCI Form A-7) from the Resident, Responsible Party or Conservator.

The Point Person should then ask a Charge Nurse from the nursing station who provides care for the Resident to obtain a telephone order from the physician or fax the requesting order to the primary care physicians office for his/her signature.

The designated Point Person, usually the Social Service Director should then fax the “Consent for Treatment” and a copy of the “Physicians Order” to our office at (619) 466-2662.  Place this completed referral package (the originals) in the GCI psychologists’ mail box or hand deliver it during his/her next visit to your facility.

• Physicians Order states: “Psychologist to assess and treat if indicated”.
• Physicians Orders that are acceptable must include the date and signature of the nurse receiving the order.
• PRN Orders are not acceptable.

STEP 3 .

Assessment:Performed by GCI Psychologist

When the Initial Psychological Assessment has been completed by the psychologist from Geriatric Counseling, Inc., it will be given to the Point Person for discussion of the recommendations by the GCI psychologist, at the next IDT meeting.

The Psychological Assessment (GCI Form A-10) will then placed into the Residents chart by the Point Person.  This way the Point Person and the facility IDT staff are always kept in the communication loop.

STEP 4 .

Therapy Visits: Performed by GCI Psychologist

Therapy visits will begin AFTER we receive verbal acceptance from the facility staff regarding our recommendations.

THE POINT PERSON SHOULD DO THE FOLLOWING:

• Fax the Residents Face Sheet along with the completed and signed “Referral Form” (GCI Form A-9) to the office of Geriatric Counseling, Inc. at: (619) 466-2662.

• Wait for confirmation from Geriatric Counseling, Inc., that insurance coverage has been verified.  This usually takes only a few minutes.

• Obtain a signed "Consent for Treatment” (GCI Form A-7) from the Resident, Responsible Party or Conservator.  Then ask the Residents Charge Nurse to obtain the “Physician’s Order” and fax them to our office at (619) 466-2662.

Place this completed referral package (the originals) in the assigned mental health clinician’s mail box or hand deliver it during his/her next visit to your facility.

TIP: Have the “Consent for Treatment” GCI Form A-7 signed by the Resident, Responsible Party or Conservator during the admission process and this will avoid additional work later.  If we need the Consent we will already have it, thus eliminating the need to obtain it later.

NOTES TO REMEMBER:

Do not obtain the Physicians Order until after insurance eligibility has been verified by the staff at GCI and we have verified the Resident has adequate coverage.

As with any outside vendor referral there is some paperwork involved.  This only takes a few minutes and these few minutes can save staff members hours of additional work in the future weeks and months.

When approaching a Resident use the term “Counselor” instead of psychologist.  Many older Residents do not understand the difference between a psychiatrist and a psychologist, or the Resident may be fearful of being labeled “crazy”.  Using the term “Counselor” is non-threatening.

It is often a good idea to have the Resident, Responsible Party or Conservator sign our “Consent for Treatment” GCI (Form A-7) during the admission process as standard protocol.  Utilizing this approach to obtaining consent is simple, if needed we have it on file in the Residents medical chart, and if it is not needed we do not have to worry about it later.