What Is Coordinated Care Management (CoCM)?

The CoCM model is based on research that collaboration between your pediatrician and behavioral health specialists can improve your child’s behavioral health symptoms. CoCM requires three team members work together to support your family’s goals:

1) Your child’s primary care provider (PCP) from Allegro Pediatrics*

2) A child/adolescent psychiatric provider from Bend Health*

3) Behavioral Health Care Coordinators from both Allegro and Bend Health. All patients enrolled in the program are proactively tracked through a registry, so no one falls throughthe cracks. Treatments are evidence-based, and patient progress is tracked monthly to ensure targetsymptoms are improving

Bend is unique among CoCM programs because they also include a behavioral health coach in every patient’s care team. Some patients also qualify to have a Bend therapist added to their care plan.  

*Note: In order to qualify for CoCM, patients cannot receive care from another psychiatrist or pediatrician during the time they are enrolled in the program.  Patients may choose to add or continue care with an outside therapist in addition to family coaching through Bend Health.

Why Should My Family Consider CoCM?

This program’s goal is to help our patients get quicker access to specialists and to support your ability to pay for the behavioral health care your family needs. Allegro's partnership with Bend Health allows us to bill your medical insurance when your child receives behavioral health support. The CoCM model tries to address the fact that most families do not have separate insurance coverage for mental health, and few can afford the rising, out-of-pocket costs.

How Do I Know if My Insurance Accepts Bend Health?

Coordinated Care Management (CoCM) billing must be submitted to insurance by your pediatrician.  Your Allegro PCP is already credentialed with your insurance company, so your plan should include this type of care.  It is important that you understand your bill will come from Allegro despite the virtual care being provided primarily by Bend Health.

Our CoCM program tracks the total time each team member spends supporting your child, and a bill is sent at the end of each calendar month.  Most patients receive up to two hours of support per month, depending on your goals and participation level. 

One advantage of this model is that the time your family spends with Bend’s psychiatric provider, Bend’s coach, and Bend’s therapist is billed at the same rate as a care coordinator.  Those rates are less expensive than what each specialist usually charges for care outside of a CoCM program.

One thing that can be confusing for patient families is that all time is billed, both face-to-face time in virtual sessions and care behind the scenes tracking your child’s progress and coordinating care between care team members

How Much Will My Insurance Cover?  How Much Will My Family Have to Pay?

Each insurance plan is different. It is important that you contact your health insurance to see how the CoCM codes below are processed under your specific plan’s benefits. This will allow you to calculate what your out-of-pocket responsibility might be. The collaborative care codes will be subject to your annual deductible, co-insurance, and co-pays. These can differ from other mental health benefits.

• 99492 – first 70 minutes of care in the initial month of CoCM
• 99493 – first 60 minutes of care in any subsequent month of CoCM
• 99494 – each additional 30 minutes in any month (in addition to 99492 or 99243)
• G2214 – first 30 minutes of care in any month (instead of 99492, 99493 if   < 30 minutes)

 Contact Allegro’s billing office at 425-460-5601 for any questions regarding the cost of these services

 

What Can My Family Expect from Each of the Various CoCM Team Members?

• Allegro PCP: identifies patients in need, refers to Bend Health, co-manages patient care plans, prescribes meds if needed, orders labs/EKGs if needed, reviews care summary each month.

• Allegro Care Coordinator: reviews patient referrals, maintains a patient registry, helps patients navigate the CoCM model, facilitates communication between Bend, PCPs, and patients.

• Bend Care Coordinator: helps patient families navigate the Bend system, facilitates care delivered by Bend, encourages patient families to practice skills and provide monthly feedback, communicates with your Allegro care team.

• Bend Psychiatric Provider: oversees patient evaluation and diagnosis, creates initial care plan, reviews patient progress/questionnaires monthly and adjusts care plan as needed, recommends medication if needed.

• Bend Coach: meets virtually with patient families for up to three 30-minute virtual sessions per month to teach skills from 20 specific evidence-based programs (e.g., Anxiety, OCD, Safety, Neurodiversity, Depression, Vaping, Executive Function, Sleep, School Related Stress, Tapering Down Tech, Body Image, etc.)

• Bend Therapist: can be added to your care plan if your child needs more support than family coaching alone. Sessions are split between coaching/therapy to keep total time less than 2 hours per month.

• Bend Nurse: connects with patient families who start or change medication.  They make sure your family understands the risks and benefits of the recommended medicine.  They also help monitor for side effects during changes.

CONSENT FOR CARE

My family would like to enroll in the Behavioral Health Coordinated Care Management (CoCM) program with Allegro Pediatrics and Bend Health.