How to create / scale up a cost-efficient behavioral health practice

Behavioral Health Service Practice Challenges

Behavioral health practice faces multiple challenges form its initial start-up to scaling-up its operation for service delivery.

Behavioral Health Service (BHS) practitioners would prefer to focus on delivering behavioral treatments to its clients. Current BHS practitioners spend considerable time in addressing its operational challenges.

It starts with a lack of BHS recording system, much like what an Electronic Health Record (EHR) providing support for the medical practice. EHR systems provide patient medical record capabilities supporting with a revenue management through its reimbursement submission to healthcare payers. BHS practice needs a client BHS recording system, not available from most EHR solutions. BHS practice can leverage the reimbursement submission capabilities from EHR solutions.

But without the client BHS recording capabilities, BHS practices are left with few options: either go paper-based oriented approach or pay a significant fund for customization from EHR systems. Going paper-based approach include the traditional forms,  scan into PDF format and then upload to the EHR systems. Such recommended approach is very similar to keeping paper records. The second approach is to pay EHR professional service team for customization of BHS recording capability. This approach is costly – both with initial development as well as long term maintenance. Most small and medium BHS practices do not have the financial support for this approach.

Piling on top of the lack of BHS recording capability is the challenge for CARF accreditation. CARF is a gold standard BHS delivery and would open door for BHS practices to accept private healthcare insurance payers. Such expansion will be welcome given a lower, limited Medicaid state reimbursement. CARF accreditation requires a set of policies in compliant with quality BHS delivery, proofs on BHS delivery supported by BHS staff and data / documentation. With EHR systems not supporting the basic BHS recording capabilities, supporting CARF compliant requirements are out of question for BHS practices; hence, it eliminates the opportunity to scale up the operation, both in term of potential higher reimbursements and higher quality of service delivery.

BHS practice is a business entity with revenue and cost tracking to ensure its operational longevity. If we assume that there is an EHR solution addressing all the above challenge, the inability to reconciliate between the service delivery system and the financial software solution such as QuickBooks is critical for the BHS practice.

How would the organization reconcile the payment received with the account receivable and cash flow from the financial side? Without such reconciliation, how would the organization can confidently handle pay bills / payroll activities? To overcome this gap, BHS practices must hire additional staff to perform the tasks, manually. This action will result in higher operational cost – which in turn, threatens the longevity of the operation.

Let us step back and summarize BHS practice challenges:

  1. EHR provides good coverage on revenue management. BHS practice can leverage this capability to manage its revenue management.
  2. But EHR system has limited to non-existing capabilities to support BHS delivery to its clients via its recording capability.
  3. Without the BHS recording capability, BHS practice falls deeper in the ability to be CARF accreditation, removing its opportunities to get additional higher reimbursements from private healthcare payers.
  4. Compounded by the above challenge, BHS practice has to fill in the gap between its service delivery and financial operations. Lacking the reconciliation capability[1] will increase the operational costs as it must be provided manually by hiring additional staff.

Integrated Behavioral Health Service with Zoeticx ProVizion BHS

Zoeticx ProVizion BHS covers all BHS treatment levels: Residential Treatment, Intensive OutPatient (IOP) and OutPatient (OP).  The application suite supports all required data and workflows in order to be CARF compliant. The application suite has proven its ability to be the critical function to lift a BHS organization to CARF accreditation.

To leverage with HIPAA compliant revenue management capability, Zoeticx ProVizion BHS can be delivered with embedded OpenEMR solution. With this integration, Zoeticx ProVizion BHS addresses the need for revenue management and secure reimbursement filings with healthcare insurance payers.

Zoeticx ProVizion BHS integrates with Intuit QuickBooks to reconcile the service delivery and financial operations, reduces the need for additional staff to perform the tasks manually. A reimbursement submission to OpenEMR is also linked with an account receivable being updated on QuickBooks. With such integration, payments can be reflected on both OpenEMR and QuickBooks; therefore, BHS practices can leverage the remaining financial functions such as paybills, payroll from its cash flow update.

Our commitments

The solutions are integrated and tested. There is no requirement for BHS practices to seek additional professional services – both on IT integration as well as worklows supporting BHS client recording, CARF accreditation to reconciliation between all the systems.

The solutions are cloud-deployed, eliminating the need for local IT support.

With Zoeticx ProVizion BHS, BHS providers can finally focus on what they do best – delivery BHS treatments.