Behavioral Healthcare and Substance Abuse
Employers are increasingly looking for more effective ways to retain and develop employees. They expect service providers to offer a wider range of interrelated services that will provide assistance to employees dealing with issues that confront them every day. Behavioral Health Systems has developed personalized programs to meet the specific needs of employers, and their employees.
Under the BHS model, the focus of care is shifted from professional-centered care toward a participative, consumer driven plan of treatment designed to personally engage the member in a process of recovery that will lead to long-lasting results. With an emphasis on early intervention and clinical excellence, we consistently deliver care in the least restrictive manner. By working in a consultative manner with our providers and monitoring the treatment process to provide support to the member, we ensure positive outcomes at an affordable cost.
Our continuum of care includes:
= Assessment and Care Management Clinicians
= Private Outpatient Practitioners including Psychiatrists,
Psychologists, Professional Counselors and Social Workers
= Outpatient Clinics and Day Treatment Centers
= Outpatient Substance Abuse Programs
= Inpatient Psychiatric Hospitals and Units
= Substance Abuse Rehabilitation Facilities
Who Can Benefit?
Any size company with a self-insured benefit structure can benefit from our behavioral health and substance abuse programs. These services are simply “carved out” of the current health benefit plan and are administered directly by BHS with a full complement of support (claims processing, information reports, etc.), and with minimal conversion impact on the company’s employees. BHS programs are ideal for companies with multi-site employee locations.
How Does the Program Work?
One in five adults and children suffers from a behavioral health disorder at some time during a year. Only 50% of these individuals receive treatment. Researchers have found that 64% do not know where to turn for treatment and 85% are concerned about the cost of obtaining assistance. As a result, a significant number of employees continue their daily activities at less than full capacity, with more absences from work, and increased medical expenses.
The BHS model seeks to "normalize" a person's experience with behavioral disorders, building self-esteem and self-efficacy to overcome barriers to treatment and integration in normal daily activities. BHS provides information to employees about the importance of their emotional health and how to take action when events or situations feel beyond their control.
Once an employee makes a decision that behavioral change is necessary, the road to recovery begins.
Taking the First Step
The road to recovery begins either with a simple telephone call to one of our highly qualified Care Coordinators who are available 24 hours a day, seven days a week or a brief message via the internet.
Face-to-Face Assessment
BHS network clinicians provide a comprehensive, face-to-face assessment of the employee's needs. At the conclusion of the assessment process, the employee and the provider agree upon a plan of treatment that is specifically designed to meet the lifestyle and demands of the employee.
Review of Treatment Plan
The proposed treatment plan is reviewed by BHS to ensure that treatment is medically necessary and appropriate and will be rendered at the optimal setting.
A New Kind of Network
Members deserve the assurance that they are receiving the right care from the best professional available. BHS maintains a national network of fully credentialed professionals and facilities.
Monitoring
The BHS model of intervention emphasizes sustained monitoring of the treatment process. These services include intensive, case by case monitoring, pre-certification and concurrent review if inpatient services are necessary, evaluation of progress toward goals, assessment of need for alternative treatment and discharge planning.
Building Support
BHS seeks to enhance the availability and support capacities of the family, the community, and other social organizations to persons recovering from behavioral health disorders.
Care Enhancement Programs
BHS involvement does not end with the discharge of an employee from a program. BHS's Care Enhancement Programs provide ongoing monitoring, feedback and encouragement to insure against repeated episodes of illness.
Claims Administration
BHS offers a full range of administrative services including eligibility verification, claims adjudication and payment. Behavioral healthcare claims are paid within 30 days of receipt.
Management Reporting
BHS provides employers with state of the art reports including comprehensive statistical and savings reports, utilization reports, employee satisfaction surveys, selected outcome studies, and a comprehensive quality management program.
