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.
Discharge planning is the development of a personalized plan to ensure the smooth transition of a patient from a health organization such as a hospital to wherever the patient is going next such as a home, residential care, palliative care or somewhere else.
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.
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.
ASAM Criteria set guidelines for length of stay and level of care for behavioral health. BHM Healthcare Solutions offers objective peer reviews based on medical necessity criteria, like ASAM's, for complex, medical, and behavioral health cases.
Understanding the Vital Role, Challenges, and Opportunities of Independent Medical Review Services, offers a behind-the-scenes look at internal and external appeals, reasons why accredited IROs reduce risks, and a crash course on newer review services, such as the independent dispute resolution process that’s part of the No Surprise Act (NSA) surprise billing regulations.
An Independent Review Organization (IRO) deliver independent medical peer review services designed to ultimately reduce administrative costs and ensure patients receive proper treatments. Rising healthcare costs affect millions of people daily. Providers and insurers can rely on IROs to help them to control costs and offer affordable coverage.
Over the last few years, there has been a rapid switch in organizations allowing and encouraging Work From Home (WFH) options. This switch has occurred at an unprecedented pace and much about this change on such a large scale is still unexplored. While BHM has always had a very strong background in data analytics and reporting, we took this opportunity to explore ethical and fair productivity metrics to allow for data-driven decision-making around our WFH practices.
Stress, anxiety, and depression are among the most prevalent for injured workers. If left untreated, they can render a seemingly straightforward claim nearly unmanageable, resulting in poor outcomes and exorbitant costs. Increasingly, many in our industry are recognizing the need to proactively do all we can to address this critical issue. Open discussions and gaining a deeper understanding of a subject that, until now, has been taboo.
Psychiatrist shortage by the numbers: The current workforce of about 45,580 psychiatrists must increase by 2,800 to meet today’s demands for psychiatric care. This works out to a 6.4 percent shortage. By 2025, that shortage could be as high as 6,090 psychiatrists, or 12 percent, according to the U.S. Department of Health and Human Services.