II.D REFERRALS AND INSURANCE *

Effective Date: 
Fri, 08/01/2008
Reviewed: 
Tue, 04/17/2018
Revised: 
Tue, 04/17/2018
Procedure: 

1. Referrals to Off-Campus Providers

Referrals are made to private therapists, private psychiatrists, or community agencies when the treatment of choice is not available through CAPS or when individuals are not eligible for services.  The list of off-campus treatment providers, their areas of clinical expertise, and their availability is maintained in a database and is updated frequently.                                         

If at all possible, at least three referral names are provided.  Students are either told the referrals names during their contact with CAPS clinician, sent the names in a secure message on their Student Health Communicator, or provided a list when they come in to pick up their referral form (if applicable).  It is the referring clinician's reponsibility to determine the level of follow-up necessary to ensure student's connect with an off-campus provider, and provide whatever follow-up is indicated.  In the event the referral becomes complex, a case management referral can be made.  In the event a student is endorsing concerning risk factors, the referring clinician should continue to follow the student until a successful referral is made, and attempt to secure a release of information for the referred to clinician. Depending on acuity, the clinician can choose to send a letter to the client’s last known address, in the event the student does not follow-thru on referral recommendations.

Students who do not endorse any concerning risk factors require no follow-up.

To ensure continuity of care, every effort should be made to secure a Release of Information (ROI) when an at-risk student is transferred to an off-campus provider or facilitity.  Similarly, when the treatment of a student is shared between CAPS and an off-campus provider or facility, an effort should be made to secure an ROI to help coordinate care.  If there is no ROI in place, a FERPA Health and Safety Emergency Exception, or HIPAA Care Coordination provision may be implemented if indicated.

2. Undergraduate and Graduate Insurance (USHIP/GSHIP)

If a student is referred off-campus who has the student health insurance, the CAPS clinician making the referral must complete an Off Campus Referral form in the electronic health record.  The student then brings this form to their off campus appointment.

a. A New referral form is the first referral form given to a student for psychological treatment.  A Renewal referral form is any form given after the initial New referral form expires and the student continues to need treatment.

b. All insurance forms expire just prior to the beginning of Fall Quarter in September.  Renewal referral forms are needed at this time for continued coverage.

c. CAPS may back-date renewal referral forms if the student’s file contains documentation of a prior referral within the past year.  This is done when students request a renewal referral form after coverage has already expired.

d. Student insurance referral forms must be requested by the student.  CAPS will not process or release a referral form for anyone but the student.

e. Students can contact CAPS through phone triage to get a referral.  The referral form can be sent electronically to the student through the Health e-Messenger system if "Prepare PDF" is selected by the clinician.  The student can also come to the main CAPS office to pick up a referral form.  At that time, an electronic copy of the referral form is automatically sent to the insurance company.  Students are given a copy of the referral, which they need to bring in to the off-campus clinician.

f. Off campus Providers do not need a copy of the insurance form to be paid by the insurance company.  The copy is given solely for the clinician’s record.

h. CAPS does not mail or fax clinicians copies of new or renewal referral forms.