Behavioral Healthcare Management
The Most Cost Effective Program Available
Interface’s Behavioral
Healthcare Management Services provide a proactive approach for increasing
value while controlling cost for Mental Health & Substance Abuse (MH/SA)
treatment, thereby reducing overall medical costs for the self-funded
health plan. It “carves out” the management of MH/SA treatment, while
keeping the payment of health plan claims in the self-funded plan.
The goal of the Behavioral
Healthcare Management Services is to ensure each participant receives
appropriate treatment in the most cost efficient manner. This is a simple
idea in theory but more difficult to put into practice for many employers.
Interface’s program receives very positive feedback from network
providers. Many providers mention how refreshing it is to work with a
managed care company who sincerely cares about the patient.
Standard utilization
review and/or PPO firms have been designed primarily for the
medical/surgical portion of health plans, managing only higher levels of
treatment (e.g. inpatient hospitalization). However, unlike medical care
where surgery and other procedures are aimed at correcting the problem
while in the hospital, effective long-term MH/SA treatment does not occur
until the patient is stabilized and directed to lesser levels of care.
Managing and directing all levels of treatment is critical to increasing
the chances of a successful outcome and providing cost savings; otherwise,
the employer’s dollars are not effectively utilized.
Interface will provide the
following services for behavioral health treatment covered under the
employer’s health plan:
·
Resolution of short-term problems under the EAP without referring to the
health plan
·
Care
Management for all levels of treatment
·
Utilization Management
·
Extensive MH/SA PPO network with contracted per diems for each level of
care
·
Review and repricing of insurance billings for MH/SA treatment prior to
payment by the plan administrator
When Interface manages the
treatment from the assessment through aftercare, the value of the
treatment is enhanced. Utilizing our step-down approach, participants are
directed to appropriate treatment levels within the MH/SA PPO to ensure
positive resolution of their problem(s).
Behavioral Healthcare Management Services = the right treatment with the
right provider at the right time.
