BHM Healthcare Solutions meets your needs for conducting quality behavioral health and medical reviews, pursuing quality improvements and delivering value-added benefits to your members and provider networks. Here are 3 ways BHM rises above the competition:
BHM’s confidence shows because we stand behind our determinations.
When BHM is your delegated entity, we share the risk of the case determinations and eliminate the need for your medical director(s) and clinicians to recheck every review. BHM brings more than promises. Let us handle case reviews on-demand for you, so you can reallocate a big part of your staffing resources to focus on patient care services.
Turn reviews into an ‘as needed’ expense
Ensure turn-around-time case completion and accuracy
Relieve staff training pressure
Behavioral Health Expertise
Recognized Market Leader If you want the largest behavioral health peer reviewer network with the most specialties and sub-specialties, BHM is the only choice. Many of your most challenging claims and cases likely present a behavioral health component. Your reviewer network needs doctors with the care planning and prescription management expertise required for this growing category of care.
Behavioral Health and Medical Knowledge BHM evaluates cases based on medical necessity criteria, the most current evidence-based practices, and national, state, or local regulatory guidelines. This covers all care, behavioral health and medical. Working with BHM’s network:
Addresses recruiting, retention, and staffing concerns, particularly, for hard to find sub-specialties.
Improves your response times and ensures you comply with turn-around times defined by regulatory agencies
Enhances the quality and consistency in case reviews.
Reallocates your team to focus on other high-priority needs.
Technology and Reporting
Pushing Practical Change BHM’s web-based case processing tools set new standards for collection and storage of case data. Today, as proof of our dedication to continuous improvement, we are creating a new normal with a suite of on-demand data manipulation tools making our clients wonder how they ever managed before with their manually created reports and spreadsheets.
Conflict of Interest and On-Demand reporting Our web-based system requires and tracks the reviewer’s attestation about conflicts of interest. Our new on-demand data reporting module provides more details and categories by: TAT, Concordance rate, Case managers, Reviewers, Levels of Care (LOC).