Helping You Adjust to the Managed Care Environment

Although behavioral health Parity has been required of insurers and managed care organizations for the better part of the past 10 years, there is substantial evidence that payers have not fully implemented policies and practices consistent with parity requirements. Since 2014, SAE has functioned as an external Parity compliance administrator in NYS monitoring the progress of a health plan and its behavioral health vendor in meeting the terms of a legal settlement set by the NYS Attorney General to become Parity compliant according to the Federal Legislative Act of 2008.

In doing so, SAE has acquired the insight into the managed care utilization review process as well as the data metrics to develop an aggressive utilization review process and institutional process, and a data metrics platform to help you gain control over the claims submission process and increase your revenue. In addition, we can offer trainings that address your concerns, such as:

  • How do you launch a successful request for authorization of services?
  • How do you frame successful appeals?
  • How do you determine whether a denial is appropriate?
  • What kind of data is necessary to monitor claims denial and appeals processes?
  • What kind of data should you be developing to prepare for value-based payments?

The Parity team at SAE is available to discuss our approach, and to answer any questions you may have about how we can support your efforts to address the fiscal issues in behavioral health imposed by the emergence of managed care contracting. To do so, please contact SAE at (212)-684-4480 or email info@saeassociates.com

 

SAE Parity Podcast Series: click here

SAE Webinar, hosted by the Hospital Association of NYS: click here