BHM Payer Services deliver by lowering risk, increasing efficiencies, and maximizing profitability. Our Payer Services Refined through years of service and implementation experience, our Payer Services improve key components of your case processing.
1st and 2nd Level Reviews
Built on the foundation of our unique web-based Peer Review System®, BHM review services handle any volume of cases. Clients choose BHM for our:
Every reviewer and every review documents conflict of interest status.
Detailed data collection capabilities AND mining/analysis teasing out cost-saving trends
On-going client meetings for trend analysis, implementation training, and process improvements
Review Services Include:
Medical Chart Review
Appeals and Reconsiderations
Case Determination and customizable monthly processing reports. Our external independent review services focus on the vital components necessary for unbiased work.
Board certified panel of physicians in all major specialties
Specialization in medical necessity and experimental treatment issues
On time reviews
Clients praise our network’s professional conduct and communications. When onsite caregivers trust peer networks, efficiency and accuracy increases.
Chosen and trained for improved communication skills
Current on protocols
BHM’s has achieved a 100% success rate in client accreditation applicable to URAC and NCQA. We have combined winning strategies with efficient processes to assist each and every one of our clients in attaining their desired accreditation on time and within budget.