Utilization Reviews

Comparing Bestnotes With Behave Health: Which EMR is Right for Your Addiction Treatment Facility?

Take a look at how Bestnotes and Behave Health compare in terms of behavioral health EHR utility, value and ease of use.

What Reviews are Required for Addiction Treatment Providers Under Blue Cross Blue Shield of Tennessee?

Today, we’ll examine what utilization management reviews are required of addiction treatment providers working with Blue Cross Blue Shield of Tennessee plans.

Top 5 Addiction Treatment Diagnosis Codes to Use for URs with Healthfirst Insurance

There is no “best” addiction treatment diagnosis code (or ICD-10 code) to use when completing URs or authorizations with Healthfirst. All behavioral health diagnosis codes are subject to more or less the same utilization management decision making criteria at Healthfirst.

Understanding Addiction Treatment Discharges and Discharge Rules at Horizon Blue Cross Blue Shield of New Jersey

In network providers as well as out of network providers must complete a discharge plan before engaging patients in many addiction treatment services at Horizon Blue Cross Blue Shield of New Jersey.

Where to Find Addiction Treatment Utilization Forms for L.A. Care Health Plan 

What Utilization Forms or Utilization Reviews are Needed for Addiction Treatment Centers Working with LA Care Health Plan?

How to Handle Utilization Reviews with Blue Shield of California for Addiction Treatment

While they’ve done things like make nominal financial contributions to the cause of diversifying the mental healthcare profession, Blue Shield of California is part of a general trend in managed care to minimize costs for insurers by limiting the scope of “medical necessity,” especially when it comes to addiction treatment.

What Addiction Treatment Diagnosis Codes Should I Use for URs With Health Care Service Corporation?

HCSC has a history of denying addiction treatment claims by using overly restrictive guidelines that contradict the APA’s clinical opinion. It’s critical that you use the correct diagnosis code for every HCSC UR.

The Ultimate Addiction Treatment Medical Billing Glossary

Working with medical billing isn’t the most exciting part of addiction treatment, but it is one of the most necessary parts of a successful business in the behavioral health field.

Is Your Addiction Treatment Organization Spending Too Much Money on Collections?

Like the old saying goes: “you’ve got to spend money to make money.” 

No where is that more true than with addiction treatment billing and collections. 

Stop Struggling With Addiction Treatment Utilization Reviews in 4 Easy Steps 

Getting insurance companies to fairly reimburse for services rendered is one of the biggest struggles for many addiction treatment providers today. Between an initial verification of benefits, pre-authorizations, concurrent reviews, and even retrospective reviews, it’s easy to get lost in the insurance authorization labyrinth and spend a lot of your organization's time (and money!) fighting with insurance companies.