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Aetna Behavioral Health Employee Assistance …

A guide to providing services Aetna Behavioral Health Employee Assistance Program (EAP). 2009. A (2/09). Table of contents Introduction .. 1. Our philosophy The Aetna EAP structure Why participants value the Aetna EAP Clinical Information .. 2. EAP Call Center EAP Call Center access and hours of operation Referral process Access standards Performance-based referrals for job-related substance abuse issues Additional services available to participants Program quality assurance and improvement .. 6. Quality standards Confidentiality Participant grievances Provider relations .. 8. Provider credentialing and recredentialing Nondiscrimination Notification of status changes Aetna EAP website EAP provider satisfaction survey Aetna EAP plan designs .. 9. Descriptions Reimbursement .. 10 Forms .. 11. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. The Aetna companies that offer, underwrite or administer benefits coverage include Aetna Health Inc.

2009 A guide to providing services Aetna Behavioral Health Employee Assistance Program (EAP) 44.20.801.1 A (2/09)

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Transcription of Aetna Behavioral Health Employee Assistance …

1 A guide to providing services Aetna Behavioral Health Employee Assistance Program (EAP). 2009. A (2/09). Table of contents Introduction .. 1. Our philosophy The Aetna EAP structure Why participants value the Aetna EAP Clinical Information .. 2. EAP Call Center EAP Call Center access and hours of operation Referral process Access standards Performance-based referrals for job-related substance abuse issues Additional services available to participants Program quality assurance and improvement .. 6. Quality standards Confidentiality Participant grievances Provider relations .. 8. Provider credentialing and recredentialing Nondiscrimination Notification of status changes Aetna EAP website EAP provider satisfaction survey Aetna EAP plan designs .. 9. Descriptions Reimbursement .. 10 Forms .. 11. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. The Aetna companies that offer, underwrite or administer benefits coverage include Aetna Health Inc.

2 , Aetna Health of California Inc., Aetna Health of the Carolinas Inc., Aetna Health of Illinois Inc., Aetna Life Insurance Company, Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna Health Administrators, LLC, Cofinity, and Strategic Resource Company. Aetna Behavioral Health refers to an internal business unit of Aetna . EAP is administered by Aetna Behavioral Health , LLC and Aetna Health of California Inc. ( Aetna ). An introduction to the Aetna EAP Why participants value the Aetna EAP. Our EAP is designed to be an inviting and dynamic program with features that make it a valuable resource that members will want to use. The program features easy and confidential access to both telephonic and Web-based services, so members can quickly find the resources they need. We have leveraged our long-standing history as a leader and innovator of Health -related programs and services Aetna 's EAP was developed in response The Aetna EAP offers a full suite of to integrate our EAP into an overall to the needs of our plan sponsors services designed to meet the personal Health strategy.

3 When members (employers) and members. Our goal is needs of members and the business use the Aetna EAP, their needs are to help improve productivity, increase needs of the workplace. Standard assessed and they are guided to participant satisfaction, help members program offerings include: resources that can best meet their achieve a more satisfactory work/life . 24/7 access to trained mental Health needs. Our EAP may be able to help balance and better manage Health costs professionals them solve a small problem early on with a new approach to providing the . A ssessment and referral services before it becomes a major concern, kinds of help people need, when they . as well as encourage the appropriate Face-to-face counseling sessions need it. We believe the Aetna EAP is an use of Behavioral Health and delivered in a variety of program important element of our benefits plan medical benefits. session models offerings because of the unique services.

4 Training and education services Participant benefits it offers our members.. Management consultation supportive environment to A. Our philosophy . Critical incident support balance work/life issues: The . Interactive Web services Aetna EAP provides resources At Aetna , we believe in focusing on . for members and their families to Communication and promotion an integrated, holistic approach to help them deal with such issues as tool kit Health and wellness, where an EAP marital difficulties, substance abuse . Reporting services and other benefits are part of an overall and workplace conflicts, as well as . Work/life services, including continuum of care. Together, they help general work/life concerns such as improve productivity, increase Employee elder care, child care and legal/ elder care, child care, and legal and satisfaction and better manage financial resources financial concerns. Health costs. asy access that saves time E. The Aetna EAP structure and effort: Members can access The EAP can serve as the early point of intervention for many problems The Aetna EAP operations unit is the program conveniently and and issues that can affect a member's headquartered in Hartford, CT.

5 We confidentially, 24 hours a day, physical and mental well-being. For have developed a national network of 7 days a week. Whether by phone an EAP to be most effective, members EAP providers to service our business or via the Internet, they are should use the program to help address across the country. We have select quickly directed to the resources work and life issues before they become vendor arrangements for services they need, which can help them unmanageable. That's why we have such as work/life balance, crisis efficiently and effectively manage taken the traditional EAP concept one management and international issues that ordinarily would require step further by placing an emphasis on EAP referral. substantial time and effort. motivating and guiding members to use ersonalized service: One phone P. this important benefit. call to the toll-free number puts members in touch with a trained professional who can assess their needs and recommend an appropriate course of action.

6 1. Clinical information The primary purpose of the Aetna EAP Call Center We have Spanish-speaking Customer EAP is to provide confidential and Service staff to assist members. In timely Assistance to members and their The EAP Call Center is located addition, Aetna has full use of the family members who are experiencing in Connecticut. AT&T Language Line services. Any personal problems that may affect job We staff our Call Center with customer of the 140 languages in the AT&T. performance. This may include, but is service professionals and EAP clinicians. repertoire can be accommodated. not limited to: This group is supported by the Call The role of the Aetna EAP clinician . Family and marital discord Center manager, a trainer, and quality involves functioning as a consultant . Depression and stress management improvement and systems support to the caller regarding his/her . Financial problems personnel. One of the Aetna medical presenting problem or issue.

7 We . directors is available to the EAP staff wish to work closely with you to Grief and bereavement 24 hours a day, 7 days a week learn about your areas of specialty . Substance abuse for consultation. and specifics regarding services . Gambling and other EAP clinical staff must be licensed available to members. compulsive behaviors Behavioral Health clinicians with a The EAP team at Aetna is Members and their families can receive minimum of three years of EAP and/ supported by professionals with a predetermined number of counseling or work/life experience. A master's many years of experience in the sessions (the number of sessions is degree in the social sciences is required, delivery of EAP services. determined by the employer) that with certification in EAP and CEAP*. have no direct cost to the participant, preferred. We look for dedicated such as copayments or deductibles. If individuals who are willing to get the job counseling beyond the predetermined done and done well while showing number is needed, we attempt to assist discretion and sensitivity.

8 Providers in facilitating a smooth transition of additional counseling sessions into the participant's benefits plan. * The Certified Employee Assistance Professional (CEAP) credential was created in 1986. to identify those individuals who have met established standards for competent, client- centered practice and who adhere to a professional code of conduct designed to ensure the highest standards in the delivery of Employee Assistance services. The CEAP credential is now recognized by employers, human resources professionals, accrediting agencies and employees as the standard in Employee Assistance . The Employee Assistance Certification 2 Commission (EACC) administers the CEAP credentialing process. Aetna 's EAP clinical staff and Provider answering service. EAP emergency calls Network providers who require Relations department work constantly are always handled by Aetna 's EAP additional Assistance for members to maintain information on local Behavioral Health clinicians using the program can call us resources, such as 12-step meetings, 24 hours a day, 7 days a week.

9 For referrals, resources or support groups, community services follow-up services. EAP staff listen to the concerns of the provided through hospital systems member and/or their families. Calls Members requesting standard or and local Health providers. We are in are triaged and appropriate action routine counseling services will contact with our EAP provider network is taken. Eligible members are given be offered the option to have us as well, and we work with them to access to EAP face-to-face services. facilitate making the appointment identify the best of what is being created with the provider, or if callers prefer, in the community. Occasionally, the As a member of the Aetna EAP they may make that outreach/. Aetna EAP will work with providers to network of providers, you are among appointment on their own. support the creation of a specific service providers experienced in a wide range if there is a significant need not of therapeutic specialties and skill We offer to follow up with members being met.

10 Sets. We encourage those providers to ensure their needs have been met doing EAP work to become Certified and to ascertain their satisfaction The Aetna EAP offers a variety EAP providers (CEAPs) and to be with services. Callers with emergent of programs to its plan sponsors recognized within the network as or urgent needs receive more (employers), geared towards meeting the specialists. immediate follow-up, based on their unique needs of the corporate culture clinical needs. and Employee population. The number of visits is determined by the plan Referral process It is important to note that if sponsor, ranging from three to eight During the telephonic intake process, the nature of the call is for a session models. the Aetna EAP staff carefully screens performance-based referral/. the caller and identifies needed management request, follow up with EAP Call Center access and services, as well as geographic the provider will be done at specified hours of operation requirements.


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