Peer Review System™
Clinical Peer Review
Management Software
Peer Review Management
BHM Healthcare Solutions deliver access to a nationwide panel of behavioral health and medical doctors to independently review cases and we are still going strong after 20 years. Peer Review System (PRS™) is our Clinical Peer Review Management Software.
Insurers and health systems turn to BHM for complex care expertise.
PRS™, forms the administrative backbone for BHM’s array of behavioral health and medical review services. The web-based interface funnels case information into a standardized summary of patient care, including medical necessity criteria, case status, reviewer feedback, peer review management software, and much more.
What does PRS™ do?
Simply put, PRS™ stores, organizes, formats, monitors, and prepares cases for Medical Director review. When cases require in-depth reviews, PRS™ minimizes the challenges of collecting and organizing case information from other systems.
Whether using an EHR, in-house case management system, or basic Microsoft Office programs, your organization might be challenged by collecting and organizing case information for easy, fast, and secure review.
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PRS seamlessly shuffles the content into an easy-to-read, consistent format in a way your Medical Director can quickly and accurately make a determination before their deadlines, instead of piecing together a hodgepodge of case notes, medical criteria, and treatment plans, from many sources. Work efficiencies can ease stress leading to burnout.
PRS™ walks staff through the collection of:
- patient demographics
- turnaround time requirements
- case review reasons
- service periods
- review level
- peer-to-peer outreach, when needed
- summaries and rationales
- final decisions
- reviewer attestations
In addition to simplifying & speeding data entry, PRS™
Stores case data in formats encouraging comparative analysis
Utilizes PUSH notifications to key staff for tracking time sensitive case reviews
Tracks peer-to-peer outreach attempts, and connections
Ranks all queued cases by time, reviewer, or case numbers
Is PRS™ secure and reliable?
PRS was refined and honed by meeting the real-world needs of our large base of clients.
This is the same service we use for managing all BHM client peer review services.
As a web-based, licensed, software service, PRS:
- Helps BHM’s peer-to-peer call outreach achieve +80% connection rate
- Stores medical necessity criteria for multiple locations
- Standardizes data entry with dropdown menus
- Encourages team collaboration across locations on complex reviews
- Securely manages patient health information and doctor attestations for every case
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What does PRS™ do for your review team?
- Lowers data entry errors
- Saves staff time running to a computer to check case updates
- Ends IT hardware restrictions, encouraging full team input
- Requires very little in-house IT support
- Makes better use of Medical Director’s time
- Integrates tons of case management tools into one, focused interface
- Tracks key metrics for internal process improvement and compliance with standard, custom quality reporting