Performance Improvement Consulting

While providing high-quality behavioral health and medical review services is paramount to BHM, offering clients additional consulting services is an essential building block to quality relationships. performance improvement consulting
BHM provides the following services:

  • Medical Necessity Criteria Application Training
  • Utilization Management Submission Review
  • Clinical Consulting
utilization management, Healthcare Consulting Services

Medical Necessity Criteria Application Training

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.

Utilization Management Services

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.

Clinical Consulting and Audits

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.