HMSA’s Managed Behavioral Health program helps ensure your employees and their family members will be referred to the appropriate level of care. Through a comprehensive assessment, HMSA’s counselors determine the current treatment needs of the employee/family member and refer to a provider specializing in that treatment.

By utilizing a managed care program, HMSA is able to reduce unnecessary treatment costs by facilitating services from beginning to end. HMSA manages 100 percent of all levels of care from pre-certification and referral to on-going authorizations and discharge planning.

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I really appreciate all of the help you have given us, as well as all of the information you have sent. Everything will be extremely helpful as we move forward. Thank you!

EAP client

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HMSA’s Managed Behavioral Health program includes…

  • Pre-certification of all higher levels of treatment
  • Concurrent review of all higher level of treatment cases
  • Discharge planning for all higher level of treatment (including outpatient follow-up appointments within seven days of discharge)
  • Intensive Case Management (ICM) with high risk cases to identify and reduce risks, reduce barriers to treatment and optimize recovery

A written appeal process will be initiated in the case of a denial of authorization for requested services. All individuals responsible for managing the appeals of decisions have the appropriate training and credentials.