Care Planners

In Aetna Depression Management, an Aetna care planner serves as a liaison among the primary care office, the patient and a mental health specialist to monitor the recommended treatment. The primary care physician can expect the following support from the care planner:

The care planner will:

• Call the patient at routine intervals (at 1, 4 and 8 weeks) and administer the Patient Health Questionnaire (PHQ-9) during the last two calls.

• Provide patient education materials.

• Document adherence to the physician’s prescribed treatment plan.

• Make at least three attempts to locate the patient for the initial call. If after this “good faith” effort, the patient cannot be located by phone, a letter will be sent to the primary care physician and patient indicating that if the patient wants to continue contact with the care planner, the patient should contact the care planner or his or her primary care physician.

In addition, the patient may have other Aetna benefits that will entitle the patient and the primary care physician to enhanced case management services, including a care management plan, evaluation of barriers to treatment, more care management calls, problem solving regarding other support services and evaluation of the PHQ-9 trending.  Aetna will let the primary care physician know when this applies to a patient.

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The care planner will:

• Send or fax a written report to the primary care physician’s office (and to the mental health clinician) after each call with the patient.

• Call the primary care physician if there is an emergency situation (for example, the patient is suicidal).

• Notify the primary care physician of any patient who has disenrolled from care management and the reasons for the disenrollment.

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