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Behavioral Health Care Coordination Program/Referral

Silversummit’s Care Management teams are available to assist members with medically or socially complex needs that may benefit from increased coordination of services and connection to other community organizations.  A Care Manager is available Monday through Friday, from 8 a.m. to 5 p.m. PST to assist with coordination of the member’s healthcare needs. Complete the form below or call Member Services at 1-844-366-2880.

Mental Health and Substance Use Care Management Form

Use this form to refer a member whom you assess as CM eligible. Silversummit will assess the member’s eligibility and respond with next steps or request more information within one week.

Asterisk (*) identifies required information field.

Referal Souce Information

Has the Member expressed interest in opting into Case Management?

Member Information

Is Member currently Pregnant?
REASON FOR REFERRAL (Check all that apply): required *