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When face-to-face services are appropriate, the Aetna
Resources For Living staff will arrange referrals. The staff
searches Aetna’s extensive database for suitable providers
based on the member’s service request and presentation.
Aetna Resources For Living staff offers several appropriate
providers to the member.
After choosing a provider and prior to the member’s first
appointment, he or she must obtain EAP authorization. This
authorization is sent directly to you. If you have not received
the authorization from Aetna, please contact us.
In some cases, according to plan sponsor specifications, a
member will be offered the option to have us facilitate
making the appointment with the provider. Or if callers prefer,
they may make that outreach/appointment on their own.
In addition to face-to-face counseling, EAP telephone
counseling is an option when clinically appropriate and a
good choice for your client. You determine if counseling by
phone is clinically appropriate when you discuss this option
with your client.
Follow-up
Aetna Resources For Living offers to follow up with members
to ensure their needs have been met and to determine their
satisfaction with services. Callers with emergent needs will
receive a follow-up call within 24 hours. All crisis calls are
followed up by telephone the following day to ensure
adequate treatment. Callers with urgent needs will receive
a follow-up call within 48 hours. Finally, when the call is for
a performance-based referral or management request,
follow-up with the provider will be done at specified intervals,
depending upon industry need.
Network providers who require additional assistance for
members using the program can call us for referrals,
resources or follow-up services.
Our approach
Aetna Resources For Living provides a holistic assessment
that looks across multiple areas of an individual’s or
household’s functioning. This assessment identifies needs
and opportunities and, in partnership with the member(s),
leads to development of a plan to achieve goals.
When short-term, solution-focused intervention is a
component of this benefits plan, the Aetna EAP network
provider pursues this work directly with the member. The
Aetna EAP network provider takes on the role of case manager
when helping the member address needs and opportunities
beyond the scope of short-term, solution-focused therapeutic
interventions. For these elements of the plan, the Aetna EAP
network provider is expected to assist in identifying resources
and linking the client.
The Aetna Resources For Living call center can assist in this
process. Often members will have a suite of services available
to them through their EAP benefits, such as legal, financial
and/or work/life services. They may also have access to
specialized behavioral health, wellness, disease management
and other programs as a part of their behavioral health and
medical benefits. The Aetna Resources For Living call center
will identify and link members to some of these additional
benefits programs and community resources.
Threat of harm
Callers who pose an imminent threat to themselves or others
are handled as emergent callers, and interventions are made
accordingly. Emphasis is placed on ensuring the safety of the
caller and others. Aetna Resources For Living will provide
immediate access to services including, but not limited to,
keeping the caller on the line while police or other emergency
personnel are called. If that notification is appropriate, Aetna
follows all federal, state and professional regulations.
In your role as an Aetna EAP network provider, if you identify
member issues that in your professional, clinical judgment
represent a threat of harm to the individual member or others
(including those in the workplace), we expect that you will
follow all applicable state laws and regulations, as well as
professional guidelines related to threats of harm, including
notification requirements.
Coordination of care
Coordination of care between the Aetna EAP network
provider and treating physicians, including primary care
physicians and/or behavioral health specialists, may be
critical to ensuring the quality of the health services the
member receives. Relevant member information will be sent
or shared with appropriate health care professionals with
proper authorization within a reasonable time frame.
Providers will weigh the clinical urgency of sharing vital
patient information with other professionals when deciding
how soon to forward the information.
Aetna Resources For Living does not provide inpatient
treatment. Members requiring inpatient treatment are
serviced through their behavioral health benefits plan.
Therefore, members requiring long-term behavioral
health case management are best managed through
the medical/behavioral health benefits plan.