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  Care Coordination  

Orange.jpgMHNet coordinates care for people, not problems - and we do it one member at a time. We tailor our treatment plans to meet the unique needs of each member by blending the most appropriate aspects of traditional behavioral health programs, preventive health initiatives, disease management, intensive case management and by coordinating collaborative care.  Case Managers, members and providers form treatment teams that work to ensure members receive optimal care at the most appropriate treatment locations.

  Disease Management  

Cyan.jpgThrough our disease management program, Case Managers use predictive modeling to proactively identify patients with documented or suspected diagnoses of high-risk behavioral health and co-morbid diseases.  Members can also be referred to the program through health plan disease management programs, medical providers, LTD/STD or Work-Life programs. Symptoms are reduced and member functioning is enhanced.  Our disease management program is designed to increase the medical community's awareness of certain diseases, educate members on symptoms and self-managed care, teach members how to change unhealthy behavior, support provider treatment plans and stratify members for intensity of services based upon risk assessment.

  Preventive Health Programs  

Green.jpgMHNet has programs targeted towards members with anxiety disorders, children with ADHD and adolescent children of parents with major depression. Additionally, we routinely collaborate with clients to provide a behavioral health complement to their preventive health or disease management programs that address high-risk and high-cost medical diagnoses. Each program is selected based upon the member population's high-volume diagnoses, demographics and risk characteristics.  Our preventive health programs identify potential problems through predictive modeling, manage high-acuity members before healthcare utilization escalates, coordinate with health plans to reduce medical costs and encourage the use of psychotherapy in coordination with medication management.

  Case Management  

Purple.jpgEach member accessing care receives case management.  Case Managers supervise member compliance with recommended treatment plans, monitor member progress and contact members directly to make sure they are receiving treatment that will lead to superior clinical outcomes.

MHNet also employs Intensive Case Management for members with concurrent medical and behavioral problems, members with chronic and severe behavioral health conditions and members who require supplemental services or have complicating factors that would result in further deterioration in the severity of the illness without intensive intervention.  MHNet's case management provides access to specialty programs and resources, coordinates treatment between providers, ensures monthly reviews are done with a medical doctor, and reduces barriers through frequent member contact while monitoring and encouraging treatment.

  Quality Assurance  

Brown.jpgMHNet's Quality Improvement Program is comprehensive and encompasses all aspects of the organization.  We conduct continual monitoring of quality care and tailor improvement activities to meet the specific needs of each member population.  Strong actions and evidence-based interventions are used to improve clinical outcomes.  MHNet ensures all performance indicators are developed, measured and managed with the same degree of rigor. Sound statistical and organizational methodology for all of our performance measures and improvement activities guarantee MHNet's best practices provide you and your members with the highest level of quality service.

  Utilization Forecasting and Utilization Review  
Cyan.jpgMHNet’s utilization programs work in conjunction with our Quality Assurance programs to ensure benefits are being used effectively.  We employ predictive modeling solutions to enhance the quality of treatment options, and we track an array of performance indicators and activities to produce concrete, verifiable utilization reports.  These reports let you see how our solutions are helping your members in a cost-effective manner.
  Credentialing  
Green.jpgMHNet’s rigorous credentialing process provides members with a robust provider network.  All practitioners and facilities are credentialed according to the National Committee for Quality Assurance (NCQA) guidelines as well as MHNet’s own internal quality assurance criteria.
  Claims Administration  

Orange.jpgMHNet offers clients full claim administration services.  MHNet's efficient and accurate claims process ensures 100% of claims are paid within 30 days with an accuracy rate of 99%.  MHNet has established the claims Service Now! team to provide telephonic assistance regarding claims issues.  Our highly trained staff members are given the authority to resolve any claim issue immediately.  Provider satisfaction with claims processing is greater than 95%.

  PsychRx  

Purple.jpgAs medication costs continue to increase, health care providers must institute reforms that address this issue while also enhancing patient safety.  MHNet’s PsychRx program meets this growing need by offering a systematic analysis of prescription data, diagnosis codes, and provider types geared towards identifying prescription patterns not in line with best practices.  The program offers targeted interventions designed to meet the needs of providers, patients and health care organizations. PsychRx aggressively addresses these problems by examining the root causes of increasing drug costs and developing practical solutions.  We apply our proprietary algorithms to pharmacy data to identify and address costly prescription issues such as poly-pharmacy and over-utilization.

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