Physician advisor

Peer Review Services

Since 2002, we supplement your utilization management process by­­­ providing medical director administrative expertise.

Our network of peer reviewers assess clinical information/documentation received in the provider service request, and, on a case-by-case basis, decide if the health care services requested from the providers are appropriate and should be paid.

We do this accurately, transparently, and in a very cost-effective ways.

Build Your Piece of Mind
BHM meets industry quality standards. NCQA-Accredited programs are eligible for automatic credit when they work with another NCQA-Accredited organizations.

Validating completeness of every request and synthesizing clinical notes BEFORE reviewer assignment means reviews based on accurate and complete records.

Integrating into the medical necessity review process or improving your denial management metrics, BHM’s network of reviewers gives you the edge..

You remain in compliance with your accreditation standards and regulatory requirements.

Clients use trend reports for identifying patterns, including red alerts and potential problem identification, to help uncover potential improvement and training opportunities for their team.

Imagine your complex cases processed as easily and as accurately as your most typical requests.

That’s the BHM difference.

BHM’s network spans the US with hands-on knowledge of CMS procedures and regulations. As needs change, the network evolves; meeting tomorrow’s demands.

BHM review services enhance your processes, not rebuild them.

The right tool for the right job means BHM recommends options addressing the pitch points in your reimbursement processing system. Our nimble on-boarding supports emergent opportunities.

Reach out to one of our client advisers. Ask how flexible behavioral health and medical expertise can be. Serving your needs with:

  • Traditional, 3rd party medical necessity reviews

  • Quality of care audits and denial management

  • Treatment Plan Assessment, including lengths of stay, levels of care, and medication review

  • Medical Director oversight for compliance requirements

  • Specialty consultations, including SUD, addictionology, ABA/Autism, and Psychological testing