Payer Best Practices, Data quality

BHM Healthcare Solutions

Pursuing excellence when serving our clients and helping deliver high-quality and cost-effective care since 2002.

Meet Our Leadership Team

about BHM

Eric Rosenberg

President

about BHM

Mary McCormick

Sales

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Eric Duchinsky

Marketing

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Rayliz Torres

Compliance & HR

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Jessica Dees

Operations

Our Purpose and Passion

Meet or exceed client requested
turnaround times and
deliver accurate results. 

Utilization Management

Network Coverage

BHM’s reviewer network represents a vast array of specialties and sub-specialties.

Audit
Process

Continuous self-auditing of reviewer performance for meeting client expectations.

TAT
Commitment

BHM’s turnaround time (TAT) commitment raises expectations for delivering accurate results.

IRO
Coordinators

IRO Coordinators oversee reviewers adding the human touch to performance metrics.

“An independent review organization (IRO) acts as a third-party medical review resource which provides objective, unbiased medical determinations that support effective decision making, based only on medical evidence. IROs deliver conflict-free decisions that help clinical [patient care] and claims management professionals better allocate healthcare resources.”

– National Association of IROs

Good question. Whether your organization is a health system or insurance company, IROs often build value by

  • Providing access to networks of doctors specializing in unique and complex care.
  • Lowering the cost of maintaining and recruiting in-house medical subspecialties and behavioral health experts for reviews.
  • Building more efficient, independent support for applying medical necessity criteria
Utilization review contains three types of assessments: prospective, concurrent, and retrospective. BHM expertly handles all aspects, including appeals.
Utilization Management

Proven History of Quality

BHM earns the most respected credentials needed for delivering the best client results.

Payers and providers know the URAC, NCQA, and HITRUST brands and their high-bar quality requirements. Our credentials fit hand in glove with your organization’s expectations.

independent review organization
NCQA Accreditation Experts, NCQA Accreditation Consulting
URAC Accreditation Consulting

Our client team is extremely qualified to help lift your organization to new heights.

about BHM

Mary McCormick

Vice President of Sales &
Account Management
Office: (888) 831-1171 x144

Alyssa Vazquez

Sales Manager

Office: (888) 831-1171 x027

Stephanie LaManna

Business Development Executive

Office: (888) 831-1171 x029