BHM is ready and able to provide medical necessity criteria (MNC) application training to your case/care managers via onsite or webinar workshops. Leveraging our expansive knowledge, BHM experts can share learnings, processes, and tips that will help your team ensure cases comply with MNC and develop a keener understanding of the nuances of applying MNC.

BHM provides Utilization Management (UM) services, including Prior Authorization, Appeals, and Concurrent and Retrospective Reviews, using licensed medical or behavioral health professionals. Written reports and communications follow all client policies and guidelines, current National Committee for Quality Assurance (NCQA) Healthcare Organization Standards, and Utilization Review Accreditation Commission (URAC) Standards.

Engaging a second set of eyes reveal fresh perspectives leading to process and decision-making improvements affecting care and reimbursements for future patients. As behavioral health and medical review experts, BHM Healthcare Solutions, deliver clinical audits, quality of care case evaluations, and retrospective reviews supporting continuous process improvements and quality control, including Quality of Care, Levels of Care, and Levels of Service.

Performance Improvement Consulting