Utilization Review Staff

Empower UR staff through innovation.

Empowering UR Staff

Today’s UR process is daunting and full of roadblocks, leaving staff feeling unable to complete their tasks. Behavioral Health CareChain (BHCC) equips your UR staff with tools to secure appropriate levels of care for your patients by:

Utilizing Natural Language Processing (NLP) technology to analyze, screen, and summarize clinical documentation.
Providing up-to-date, real-time patient summaries to eliminate preparation time.
Improving coordination with care teams for better patient care and outcomes.
Centralizing caseload management and communication.
Streamlining department coordination for flexibility, optimization, and team satisfaction.

Let BHCC supercharge the possibilities for you and your UR team.

Feel Prepared for UR Calls

Preparing for calls in a short time is difficult. Scanning through documents to gather evidence takes time you don’t always have. BHCC offers a better way.

Eliminate manual searches

Instant access to supporting documents significantly reduces review time. Have all relevant information for calls summarized on one easy-to-use screen.

On-time document completion

No more hunting down providers. Automatic alerts and notifications of pending deadlines and missing documents ensure that documents are completed for review calls.

Know ahead of time

Know your chances of authorization before you call. BHCC scores medical criteria’s likelihood of approval as well as for the current and alternative levels of care. Additionally, understanding a patient’s approval history can help you make your case.

Scheduling

An integrated calendar allows you to easily manage and coordinate reviews, meetings, and unplanned tasks.

Streamlined Communication

BHCC messaging allows you to efficiently communicate with staff for authorization needs without leaving a patient’s chart.

Coordinate with Care Teams

Improve communication and ensure call preparation goes smoothly. Work as a team to improve your patients’ outcomes.

Levels of Care

Before making calls, you can test whether alternative levels of care are more likely to be authorized. This allows you to make informed recommendations to the care team.

Peer-to-Peer Calls

Ensure call preparation with ease. All new evidence after the concurrent review is highlighted and easily accessible. The integrated calendars enable you to schedule peer-to-peer calls on both your calendar and the provider’s calendar.

Alerts and Notifications

Automated alerts and notifications of pending deadlines, missing documentation, and scheduled peer-to-peer calls help staff and providers complete tasks on time.

A Day in the Life in UR with BHCC

See how Behavioral Health CareChain makes your utilization review process easier to manage. Get your patients the care they deserve while saving staff’s valuable time.

Start the day with a clear, organized dashboard showing pending authorizations, follow-ups, and approvals.
Quickly access patient records and documentation seamlessly integrated from the EMR.
Collaborate effortlessly with clinical teams via centralized communication tools.
Easily access insurance information to support authorization submission and authorization.
Receive timely alerts and reminders for any expiring or past due approvals.
Spend more time on complex cases that requireing more coordination rather than administrative tasks.
Monitor real-time metrics and medical necessity evidence scoring to quickly transition into an authorization call.
Close the day knowing authorizations are up to date, patients are on track for full treatment, and administrative burden has been minimized.

BHCC equips UR staff to confidently complete and pivot between tasks without fear. Creating an effective, efficient, and empowering environment for staff leads to higher staff satisfaction and retention and improved patient outcomes.