Quality Improvement Programs

BHM Earns NCQA Accreditation for Utilization Management

2025-01-14T13:18:35-04:00By |Healthcare Fraud and Abuse, NCQA Accreditation, Physician Compensation, Quality Improvement Programs, Strategic Planning, Telehealth and Telemedicine, Utilization Management|

BHM Healthcare Solutions, Inc. Achieves Prestigious NCQA Accreditation for Utilization Management

Tampa, FL — BHM Healthcare Solutions, Inc. (BHM) is proud to announce that it has been awarded a full three-year accreditation for Utilization Management by the National Committee for Quality Assurance (NCQA). This marks the third consecutive cycle that BHM has achieved this esteemed accreditation, underscoring our consistent ability to meet and exceed evolving industry standards and deliver high-quality care management solutions.

The NCQA Utilization Management Accreditation is a mark of distinction, earned only by organizations that meet or exceed rigorous standards of quality. This recognition demonstrates BHM’s ability to support healthcare organizations with robust and reliable utilization management processes that ensure optimal patient outcomes, efficient resource use, and alignment with regulatory requirements.

What This Accreditation Means for Its Partners

BHM’s accreditation highlights its:

  • Dedication to Excellence in Care, facilitating timely and effective healthcare delivery.
  • Commitment to Operational Transparency, adhering to evidence-based practices and ethical decision-making.
  • Capability to provide a Competitive Edge, helping healthcare organizations achieve their goals while fostering trust and collaboration.

“We are honored to receive NCQA’s three-year accreditation for Utilization Management,” said Eric Rosenberg, CEO. “This achievement not only reflects our commitment to quality and excellence but also reinforces our role as a dependable partner in supporting healthcare organizations with the highest standards of care.”

This accreditation is a testament to the hard work, expertise, and dedication of BHM’s team, showcasing its unwavering adherence to NCQA’s rigorous standards. 

By achieving this milestone, BHM solidifies its position as a trusted partner in the healthcare industry, setting itself apart through a commitment to exceptional care and meaningful collaborations.

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Contacts:

  • Rayliz Torres, Chief Compliance Officer
  • Jannis Paulk, Vice President of Marketing

About NCQA
The National Committee for Quality Assurance (NCQA) is an independent, nonprofit organization dedicated to improving healthcare quality. Through its comprehensive accreditation and certification programs, NCQA sets standards for healthcare organizations to promote excellence, accountability, and patient-centered care. For more information, visit www.ncqa.org.

About BHM Healthcare Solutions, Inc.
BHM Healthcare Solutions provides national behavioral health and medical review services & solutions for health plans, health systems, hospitals, and other insurers.

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For more information, please visit www.bhmpc.com.

Intelligent Document Processing for Payer Cost Savings

2023-05-17T15:18:40-04:00By |Operational Analysis, Organizational Analysis, Quality Improvement Programs, Uncategorized|

Intelligent Document Processing (IDP) is a technology that uses artificial intelligence (AI) and machine learning to automatically extract and process data from documents such as claims forms, invoices, and medical records. This eliminates the need for manual data entry and speeds up the processing of claims and other documents.

Top At-Risk Conditions and Utilization Spikes

2023-01-12T11:12:16-04:00By |Behavioral Health Integration, Mental Health, Payer Trends, Quality Improvement Programs, Revenue Cycle Improvement, Trends, Utilization Management|

Top At-Risk Conditions and utilization spikes that healthcare leaders and stakeholders across the industry must prepare to proactively address in the upcoming year highlight the recently released, 2023 State of Health – In The Aftermath Report. The report also presents predictive findings and explores the top contributing factors of many utilization increases.

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