Our experience with Case Review, Accreditation Assistance (including the rapidly growing Specialty Pharmacy credentials), and Efficiency Audits set a foundation for your organization to grow.
Continued Stay and Admission 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:
Our physician reviewer network identifies gaps in meeting medical necessity criteria
Clinical Case Shaping
Detailed data collection capabilities AND mining/analysis teasing out cost-saving trends
Peers, trained in communications, working with onsite staff collecting important details
Review Services Include:
Denial Reviews and Appeals
BHM provides Retrospective Appeals Management providing a recommendations report. Our external independent review services focus on the vital components necessary for unbiased work.
Board certified panel of physicians in all major specialties, including behavioral health
Specialization in medical necessity and experimental treatment issues
On time reviews using best available evidence-based medicine
Physician Advisor Consults
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
Largest Behavioral Health Network in the industry
BHM’s has achieved a 100% success rate in client accreditation applicable to URAC and NCQA. Our work with our Specialty Pharmacy clients showcase our success. 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.
Performance Enhancement Consulting
BHM’s financial services team quickly and efficiently analyze and develop financial strategies positioning your organization for growth.