Authorizations

When the VOB confirms services will be covered, we begin working on an authorization request. Our team consists of trained therapists who understand the treatment process and can present authorization requests in a knowledgeable manner. Your time is valuable, and is more effectively spent with the client. With this in mind, we do the heavy lifting for you. Our trained UR team will utilize the clinical information already in your EHR system to present it in a meaningful way to the insurance–so you do not have to waste time compiling the information yourself. We complete all utilization reviews including: initial requests, concurrent reviews, discharges, appeals and peer reviews with an above-average success rate. We advocate for your clients so you can focus on their recovery.

Once we receive notice that a client will admit or has admitted to treatment we begin the initial request for authorization. Whether treatment is initially approved or not, we communicate what is happening every step of the way. On the chance that the insurance denies treatment, we will relay the information to you and provide recommendations on next steps to best help the client. Oftentimes, insurance Care Managers will request additional or specific information. In cases like this, we are diligent in following up to access the required information, in order to obtain approval, and maximize reimbursement.

Concurrent Reviews and Peer Reviews can be tedious, stressful and time consuming. Insurance Care Managers and doctors can be difficult to work with and may have their own process of reviewing client cases. We schedule the reviews, complete appeals and maintain a strong working relationship with the insurance companies and Care Managers. If a case goes to a Peer Review, BHB will complete the review, unless otherwise requested by the insurance to speak with someone specific.

After a client has been discharged from treatment we notify the insurance company.