Behavioral Health Compliance

Multiple rules and regulations exist across operational and service delivery requirements. Organizational compliance at the practice and operational levels ensure quality care and protection. The risk to not being compliant jeopardizes patient care, in terms of wellness and trust, as well as increased liability, in terms of fines and penalties. SAE provides assessments of compliancy to practice and legal standards, develops corrective action roadmaps and plans, and monitors quality improvement practices to support sustained changes. Our policy and audit expertise in mental health, addiction, and integrated care are needed assets with projects involving chart reviews, licensing acquisitions and MPHAEA.

Regulatory (State, Federal, Grants)

A comprehensive regulatory and clinically responsive uniform chart review process that includes:

  • Development of a unique and customized Scoresheet for a standardized review process that measures documentation of treatment appropriateness with specific levels of care. Elements are sensitive to recognized medical necessity criteria against state and federal requirements. This can assist with behavioral health care that may be under legal review.
    • Our scoresheets utilize a methodology to achieve the same review as a government auditing agency. The scoresheets will therefore be uniquely created to your service, and may include such items as: admission criteria, non-admission criteria, treatment planning, continued stay criteria, discharge criteria, etc.
    • Our process provides the clinical and data-driven assessment needed to identify and measure issues related to the appropriateness and quality of the individual’s treatment under question.
  • An objective clinical review. Our expert clinical review team assesses each individual chart utilizing the standardized Scoresheet developed for the identified clinical population and level of care.
  • A data-metric-outcomes approach that quantifies the appropriateness of treatment according to professional and regulatory standards of care.
  • A team of experienced and licensed clinicians and administrators.