Behavioral Health Utilization Management

IMBH goes beyond simply making medical necessity decisions by helping members connect to the most effective and cost efficient care that supports their recovery. IMBH also works with members to coordinate their behavioral health treatment with other care providers to avoid gaps in the treatment plan.

IMBH Behavioral Utilization Management Includes:

Utilization management services assist health plans and other payors by providing a multi-faceted approach to managing requests for behavioral health services to ensure the requested services are medically necessary through the use of evidence-based clinical guidelines.

Requests for services are also reviewed for appropriateness to ensure the right treatment and the right time.

Concurrent reviews performed on-site at local psychiatric facilities.

On-site staff

IMBH has care coordinators and case managers on-site daily at each of the psychiatric inpatient facilities. The on-site staff works closely with the facility, the member, and caregivers to ensure proper treatment planning and psychiatric evaluation, member and family involvement, and comprehensive discharge planning and after-care plans are established and scheduled.

Appointment reminders & follow-up

After inpatient discharge, IMBH works with the member and caregivers to coordinate and promote hospital follow-up appointments with the primary care provider, psychiatrist, therapist, and any other necessary services. Members are educated about the importance of follow-up and given reminders for appointments. IMBH staff works to identify and eliminate any barriers to continued treatment.