Levels of Care Impact Medical Necessity Review Success

Level of Care Guidelines are usually derived from generally accepted standards of behavioral health practice. These standards include guidelines and consensus statements produced by professional specialty societies, as well as guidance from governmental sources such as CMS’ National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs).

By | 2017-04-05T11:22:26+00:00 April 5th, 2017|Accreditation, Services, Uncategorized|0 Comments

Behavioral Healthcare Shortages: Causes and Solutions

The National Council for Behavioral Health and the National Council Medical Director Institute released a far-reaching report this month: The Psychiatric Shortage: Causes and Solutions. As a recognized leader in behavioral health reviews, this BHM Healthcare Insider Blog brings selections from the executive summary focusing on the behavioral healthcare shortages and solutions.

Successful Delegation To Downstream Entities

Healthcare organizations face challenges regarding reduction of their medical and administrative costs because regulatory and administrative demands are increasing. Payers and providers must evaluate new partner relationships and solutions for work processes and potentially outsource administrative functions in order to offer competitively priced services to patients. Successful delegation requires planning.

By | 2017-04-04T17:27:42+00:00 March 29th, 2017|Compliance, Operational Analysis, Uncategorized|0 Comments

Behavioral Health Costs: Success Stories

Managing behavioral health costs challenges the US healthcare system. The issues encompass many of the legacy processes and structures needing to be overhauled. Some interesting recently posted examples may show the way for the entire healthcare system. These come from both payers and providers.

AHCA Impact On Payers

The American Health Care Act (AHCA) made its debut. Not many people in government and healthcare industries expect quick passage of the AHCA in its initial form, but understanding the differences with the Affordable Care Act (ACA) sets a framework for how payers prepare for the final version. Fair to say, every organization must make adjustments and the pressures for building internal organization-level efficiencies increase.

By | 2017-04-10T11:59:00+00:00 March 14th, 2017|Trends, Uncategorized|0 Comments

AHCA Impact On Providers

The American Health Care Act (AHCA) made its debut. Not many people in government and healthcare industries expect quick passage of the AHCA in its initial form, but understanding the differences with the Affordable Care Act (ACA) sets a framework for how providers prepare for the final version. Fair to say, every organization must make adjustments and the pressures for building internal organization-level efficiencies increase.

By | 2017-04-02T13:27:54+00:00 March 14th, 2017|Trends, Uncategorized|0 Comments

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