The Behavioral Health Underground

<p>Behavioral health organizations are facing a perfect storm: expanding prior authorization requirements, increased prepayment and post-payment reviews, more clinical denials, and growing pressure on already-thin cash reserves.</p><p>In the first episode of Behavioral Health Underground, Sonda Kunzi and Gary Humble examine what these changes mean for mental health and substance use disorder providers. They discuss the operational burden of utilization management, the importance of peer-to-peer reviews and appeals, the risks of billing a lower level of care when a higher level was delivered, and why strong documentation must reflect more than clinical need alone.</p><p>The...