Medical Group Services

We offer a collection of behavioral health management services. From utilization management to case management, we create seamless coordination of care and benefit management for our clients to effect better outcomes. Simply put, we enhance the behavioral health referral process so patient benefits are used in the most valuable and cost effective way.

Utilization Management

Network Management

Case Management

Expertise and Specialty

Access Line

Reporting

Utilization Management

We provide expert counsel on behavioral health needs including the over and underutilization of covered benefits.

BCP authorizes benefits at every level of the behavioral health spectrum from outpatient medication management and counseling to inpatient psychiatric and detox care. We monitor referrals for appropriate level of care, length of stay, and benefit utilization.

Network Management

There is no one-size-fits-all when it comes to behavioral health services. What works for one patient may not work for the next.

Unless you are fully entrenched in the behavioral health landscape, it can be hard to know when and where to refer.

Because we focus solely on behavioral health we are able to connect your patients with specialized providers including psychiatrists, APNs, PAs, psychologists and counselors within the standard acceptable referral timeframes.

Our network of strong provider relationships ensures that patients get access to treatment in a timely manner, which helps our clients see better health outcomes for their members.

Case Management

We help patients navigate the behavioral health system while keeping them accountable to their health goals.

The case manager is responsible for patient outreach, goal setting and tracking, and care coordination for both routine and complex cases.

In addition, given the high co-morbidity of medical and behavioral health issues, the case manager coordinates care with medical case managers as necessary.

Expertise and Specialty

Our team solely focuses on behavioral health benefits and is led by a board-certified psychiatrist who is involved in the daily oversight of the clinical team.

Our clinically licensed utilization review staff provides prompt response to all levels of behavioral health benefit inquiries and utilization requests.

We specialize in management of the following plans: BCBS IL HMO, BCBS HMOI, BCBS HMO Blue Advantage, BCBS HMO Blue Precision, BCBS HMO Medicare Advantage.

We also work closely with our IPA clients to integrate into their existing workflow. We address the best way to input referrals, authorizations, and notes into our clientʼs existing system so services are able to be approved quickly and the workflow is efficient from referral, to authorization to claims payment.

Access Line

BCP offers a 24/7 Access Line for Behavioral Health triage and referrals.

Patients and providers can call to speak with a professional who will connect them with appropriate treatment options.

We have established relationship with quality behavioral health facilities. We regularly utilize the Linden Oaks Behavioral Health system for higher levels of care and an extended network of outpatient providers throughout our clientsʼ geographic areas.

We work closely with our clients to either utilize our existing provider network or to assemble a unique network that meets their specific geographic and population needs.

Reporting

We provide regulatory and payer specific reporting to our clients for utilization management and quality purposes. We also monitor reporting trends and recommend initiatives to our clients to stay ahead of the curve.

We collaborate with clients about how to best interpret their utilization data. This is helps our clients better understand the needs of their patients, as well as barriers to accessing care.

Our knowledge about payer reporting gives our clients a competitive advantage.

A note about risk
BCP does not administer claims or assume risk. We work with our clients to utilize their existing authorization system for our referrals/authorizations so that all behavioral health information is maintained on the same system as their medical information. This allows for seamless communication between our clients and behavioral health providers at all levels of care.