Behavioral Health Integration: What A Care Coordinator Should Know


Recommended timeline: approximately 12 weeks (self-paced)




In 2017 Medicare established a new benefit for Medicare Beneficiaries – BHI for primary care.  This benefit allows primary care providers the opportunity to receive payment for managing the behavioral health care of their patients. Integrating behavioral health care with primary care is widely considered an effective strategy for improving outcomes for the millions of Americans with mental or behavioral health conditions.

A large portion of patients in a primary care practice suffer from a behavioral health problem. Most elderly persons with a mental health diagnosis are treated exclusively by their primary care providers. Access to mental health care is lacking. Medicare recognizes that a team-based approach to behavioral health treatment using evidence-based tools and building provider/patient relationships will improve outcomes and save money.

This course is designed to provide health professionals, such as Nurses, primary care clinical staff and alike, with the knowledge, skills, and abilities to provide BHI services including use of validated (symptom) rating scales, systematic assessment and monitoring and use of an individualized plan of care.

Delivery Format:

The course is divided into six (6) modules. Each module may take up to two (2) weeks. The development of understanding the process to provide BHI occurs when knowledge and practice are combined. This BHI: What a Care Coordinator Should Know Certificate Course will put knowledge into practice as participants are immersed in this self-paced course with interactive discussion boards and optional monthly check-ins with the instructors. The education will be delivered in a virtual environment using a combination of pre-recorded didactic presentations, asynchronous discussion threads, and a virtual meeting space for a live monthly discussion with the instructors.


Module 1 – BHI overview
 – Background of behavioral health
– Purpose of BHI
 – Components of BHI

Module 2 – Validated tools and systematic monitoring

– Measurement-based care

– Validated clinical rating scales

– Systematic assessment and monitoring using applicable validated rating scales

Module 3 – Care Planning and Community Resources

– Developing a personalized plan of care

– Monitoring, evaluating and revising the plan of care

– Thinking outside the box r/t community resources

Module 4 – Psychiatric Collaborative Care Services

– Review of General BHI

– Discussing the purpose of using Collaborative Care Management (CoCM)

– Discuss the additional elements needed for CoCM

Module 5 – Contracting and Credentialing Psychiatric Medical Professionals

– Review the elements of Collaborative Care Management

– Setting up the program based upon the CoCM Model

– Organizing the weekly care conferences

– Discuss the legal ramifications of the weekly conferences

– Documenting the care conferences

Module 6 – Reimbursement for BHI

– Coding and Reimbursement for BHI

– Reimbursement for FQHC and RHC

– General vs Collaborative BHI reimbursement


At the completion of this course, the participant will be able to:

– Understand the background and intent of BHI.

– Explain care management for BHI.

– Understand the registered nurse’s role in care coordination.

– Identify and explain the components of BHI.

– Understand the importance of using measurement-based care in BHI.

– Interpret validated tools used for different behavioral health conditions.

– Monitor tool results for improved outcomes.

– Develop a patient-centered individualized behavioral health plan of care.

– Recognize importance of monitoring, evaluating, and revising plan of care.

– Understand the facilitation of behavioral health services and community resources to improve symptoms and quality of life.

– Understand the difference between general BHI and CoCM

– Explain the purpose for using Collaborative Care Management

– State the elements of CoCM Model and the impact on patient privacy and patient agreement

– Conduct the weekly care conference adhering to contractual boundaries

– Identify the legalities surrounding the CoCM Model

– Document the information in the registry per contract or agreement

– Explain the rules and regulations regarding BHI reimbursement.

– Provide billing codes and supplemental material to enable billing for BHI.

Continuing Education Credit Calculations:

Module 1: Objectives 01-04 / Recommend 2 wks per module / Asynchronous Discussion & Clinical Practice (3 Hours); Recorded Lecture (30 Minutes) / 1.5 hrs

Module 2: Objectives 05-07 / Recommend 2 wks per module / Asynchronous Discussion & Clinical Practice (3 Hours); Recorded Lecture (30 Minutes) / 1.5 hrs

Module 3: Objectives 08-10 / Recommend 2 wks per module / Asynchronous Discussion & Clinical Practice (3 Hours); Recorded Lecture (30 Minutes) / 1.5 hrs

Module 4: Objectives 11-12 / Recommend 2 wks per module / Asynchronous Discussion & Clinical Practice (3 Hours); Recorded Lecture (30 Minutes) / 1.5 hrs

Module 5: Objectives 13-16 / Recommend 2 wks per module / Asynchronous Discussion & Clinical Practice (3 Hours); Recorded Lecture (30 Minutes) / 1.5 hrs

Module 6: Objectives 17-18 / Recommend 2 wks per module / Asynchronous Discussion & Clinical Practice (3 Hours); Recorded Lecture (30 Minutes) / 1.5 hrs

Total:  9 hrs

Continuing Education Credit Information:

HealthTech Management Services D/B/A HealthTech is a Provider approved by the California Board of Registered Nursing. Provider Number CEP8769 for 9.0 contact hours. Participant must complete all course work – no partial credit will be given. A certificate of completion will be provided by HealthTech within 30 days of successful completion of the course.

Refund / Cancellation Policy:

Cancellations received in writing prior to the start of the course will be refunded, less $50.00 administrative expense. Registration fees may be transferred to another individual prior to the start of the educational offering.  Individuals who enroll in an online educational course and who open any module content will not be eligible for refunds.


Faith M Jones, MSN, RN, NEA-BC

Director of Care Coordination and Lean Consulting, HTS3

Faith Jones began her healthcare career in the US Navy over 30 years ago. She has worked in a variety of roles in clinical practice, education, management, administration, consulting, and healthcare compliance. Her knowledge and experience span various settings, from ambulatory to inpatient to post-acute. In her leadership roles she has been responsible for operational leadership for all clinical functions including multiple nursing specialties, pharmacy, laboratory, imaging, nutrition, therapies, as well as administrative functions related to quality management, case management, medical staff credentialing, staff education, and corporate compliance. She currently implements care coordination programs focusing on the Medicare population and teaches care coordination concepts nationally. She also holds a Green Belt in Healthcare and is a Certified Lean Instructor.

Heather K Gilchrist, DNP, RN

Heather K Gilchrist, PLLC, Owner & Independent Contractor for HTS3

Heather Gilchrist began her career as a registered nurse in the United States Navy and retired as a Navy Commander after 24 years of active service.  Prior to receiving her commission, she served in the Air Force as a medical technician.  She has worked in a variety of roles in clinical practice, administration, management, and education, and has held director-level positions in nursing, staff education, and customer service.  Her experience and knowledge span both outpatient and inpatient environments, to include clinical settings in health promotion, obstetrics, and global health.  In her leadership roles, she has been responsible for the operational leadership of nursing functions, clinical staff education and training, as well as administrative functions related to quality, inpatient electronic medical record implementation, policy development, and strategic planning.

Cynthia A Christenson, MSN, RN, CPHRM, CPHQ

Christenson Consulting, LLC, Owner & Independent Contractor for HTS3

Ms. Christenson is a consultant for HealthTech.  She has been a nurse for over forty years and has rich experience in the fields of Risk Management and Healthcare Quality as well as serving as the Chief Clinical/Nursing Officer for two organizations.  She has been a member of the National Association of Healthcare Quality and the American Society for Healthcare Risk Management for many years.  She has been actively involved in preparing providers for legal defense in medical malpractice.  She has also been active in the accountable care organization arena training Clinical Care Coordinators and Primary Care Providers to meet the CMS ACO requirements.  She currently works with HealthTech assisting with the Care Coordination program.  She continues to grow and learn and is keenly interested in the emerging field of telehealth.


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