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Clinical Guidelines

PBH works with our comprehensive network of providers to ensure the utmost in quality care is delivered to our members. Our process for delivering effective care:

  • Begins with an assessment by a qualified behavioral health specialist

  • Is based on an individually tailored treatment plan developed from empirically supported strategies

  • Integrates the efforts of all health-care providers

  • Causes the least disruption to the patient and his / her family

The behavioral health services described in these diagnosis-specific Clinical Guidelines are subject to individual member's benefit plan limitations and exclusions, as well as to all state and federal regulations.  These Clinical Guidelines are intended to reduce undesirable variances in diagnosis and treatment. They were developed by nationally recognized experts and organizations, and have been adopted by PBH for use by providers and members.

These guidelines reflect current expert consensus around best practices and are not intended to replace the clinical judgment of providers. These Clinical Guidelines provided to you are not used to authorize, modify or deny care for persons with similar illnesses or conditions. Authorization for specific care and treatment may vary depending on individual needs and benefits under a member's contract.

ADHD

PBH has adopted the Expert Consensus Guideline for this disorder. If you would like the full guideline you can receive a copy by calling the PBH Provider Helpline at (800) 716-1166 or you can order it directly from Multi-Health Systems Inc., P.O. Box 950, North Tonawanda , NY 14120-0950; (800) 456-3003, x 250. 

Autism

PBH has adopted the American Academy of Child and Adolescent Psychiatry (AACAP) guideline for this disorder. If you would like to recieve a copy of the guideline, please call the Provider Helpline at (800) 716-1166 or you can order it directly from AACAP website.

Bipolar Disorder

PBH has chosen to adopt the American Psychiatric Association's guideline.

Eating Disorders

PBH has chosen to adopt the American Psychiatric Association's (APA) guideline for this disorder.

Major Depressive Disorder

PBH has chosen to adopt the American Psychiatric Association's (APA) guideline for this disorder.

Obsessive-Compulsive Disorder

PBH has chosen to adopt the Expert Consensus Guideline for this disorder.

Panic Disorder

PBH has adopted the American Psychiatric Association's guideline for this disorder.

Postpartum Depression

PBH has chosen to adopt the Expert Consensus Guideline for this disorder.

Schizophrenia

PBH has chosen to adopt the American Psychiatric Association's guideline for this disorder.

 
 

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Wednesday, August 27, 2008