Author: Eric Duchinsky

National Survey on Drug Use

National Survey on Drug Use and Health Released SAMHSA

National Survey on Drug Use and Health Released by the U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA), which shows how people living in America reported about their experience with mental health conditions, substance use, and pursuit of treatment in 2021.

Read More »
peer to peer review in medical billing

Peer-to-Peer Review Pitfalls & Solutions

A Peer-to-Peer Review is a conversation between two healthcare professionals, usually licensed doctors, over the phone discussing a patient’s case. The Peer-to-Peer (P2P) process is used to explain or clarify something the clinical record cannot convey clearly. The core of a P2P call basically focuses on matching medical necessity criteria with reimbursement criteria.

Read More »
BHM Healthcare Solutions

BHM Healthcare Solutions Organizational Structure Change

BHM Healthcare Solutions, Inc., (BHM), a leader in medical and behavioral health review services and healthcare analytics, announces the retirement of Jean Neiner, President and CEO, effective December 1, 2022. With this change, we are excited to announce that Eric Rosenberg will move into the position of President and CEO.

Read More »

Mental Health Parity at a Crossroads

More than 25 years after the first federal mental health parity protections were put in place, adequate coverage for behavioral health (BH) care, including both mental health and substance use conditions, remains elusive for many consumers with health insurance.

Read More »
CMS Star Rating

CMS Star Ratings Major Setback for 2 Insurers

The federal government hit CVS Health and Centene with lower quality scores for the health-insurance plans they sell to seniors. Star Rating scores are a big deal for health insurers, because plans that score 4 stars or higher receive bonus payments from the federal government that they can use to edge out competition by funding new health-plan benefits to attract more customers.

Read More »
Utilization review

Utilization Review vs Utilization Management

Utilization Review and Utilization Management are very critical in the healthcare continuum. While the two terms often feel interchangeable, in reality their processes and meanings actually are very different. Their differences make all the difference for improving care.

Read More »
URAC Accreditation Consulting

URAC Accreditation Consulting: Worth the Investment?

URAC accreditation consulting valuation begins with seeing the importance of earning a credential. The multifaceted world of accreditation can be daunting, from choosing the right accreditation body to getting correct documentation in place to ensure accreditation success.

Read More »
medical director risks and value

Medical Director Risks and Value

The roles and responsibilities now require stretching medical directors’ skills into contract negotiations, group dynamics, organizational development, team management, and many areas not covered in a traditional medical curriculea.

Read More »