Government payers and private insurance companies; however, have been slow to make permanent changes to how they authorize mental health funding. With the public health emergency (PHE) winding down, payers are still assessing the impact of telehealth on care access, quality, and costs. Industry experts expect ongoing changes as providers decide on permanent rules for virtual care delivery and mental health funding.
To navigate the still-evolving rules and policies of payers while also meeting the expectations of patients, behavioral health organizations need technology. In fact, the right technology stack can help organizations build more productive relationships with insurance companies by:
- Making care accessible to a greater diversity and volume of patients
- Streamlining work for greater efficiencies and lower costs
- Ensuring compliance with different federal and state regulations
- Enabling value-based care models
Let’s take a closer look at how technology helps behavioral health organizations build stronger, more productive insurer relationships.
Making care accessible to a greater diversity and volume of patients
For insurance companies, parity in behavioral health is a top priority. Insurers have faced increasing regulatory pressure to ensure parity in mental health and substance use disorder (SUD) services with medical services. Now, provisions in the 2020 Consolidated Appropriations Act (CAA) require insurers and health plans to show how they are complying with previous legislation for equitable coverage of mental health and substance use disorders (SUD) services.
This drive to behavioral health parity is complicated by the ongoing shortage of workers and the surge in demand for services, which has been a challenge for patients and providers since before the pandemic. To address these urgent needs, insurance companies who offer mental health funding are seeking to work with organizations who can make care more accessible to a greater diversity of patients. This includes patients who live in underserved areas, different races and ethnicities, LGBTQ+, intellectual and developmental disorders (IDD), and many more.
With virtual care, behavioral health organizations can offer convenient and accessible care for individuals and groups, no matter where they are or the challenges they face. Telehealth also means organizations can work with providers who have specialized skills that might not be available locally, ensuring that patients with diverse needs receive appropriate care. Online patient portals make it easy and convenient for patients to onboard and access care, from filling out forms and scheduling appointments, to using instant message to connect with their providers in between video appointments. By making quality care more accessible and available to more patients, technology can help behavioral health organizations stand out to insurance companies when seeking additional mental health funding.
Automating and streamlining work with other providers and insurers
Technology automation and integration play a crucial role in helping providers keep costs down for insurance companies and their patients. Automating workflows replaces tedious and time-consuming manual tasks. Connecting your electronic health record (EHR) software with a patient portal via open APIs can further streamline operations. Making it easy to collect patient information, automatically bill after appointments, and process payments can save time and reduce costs.
Prioritizing technology interoperability and integration has the additional advantage of making it possible to build productive, collaborative relationships with other providers. You might decide to partner with other technology vendors that can help address the full spectrum of care for patients or with just a few that complement your focus area. Integrating your EHR with other technology vendors makes it easier to work with the other providers in the patient’s care continuum. It can also reduce the time and costs of billing and payments processes.
Ensuring compliance and transparency
From HIPAA to the more recent 21st Century Cures Act and No Surprises Act, insurance companies must comply with many federal and state regulations. Insurance companies want to work with behavioral health organizations that invest in technology that meets or exceeds regulatory guidelines while streamlining compliance. Behavioral health organizations that build compliance into their technology stack give payers the visibility and transparency they need to minimize compliance risk.
HIPAA-compliant telehealth software can protect patients accessing both real-time virtual care and other services in between virtual appointments. When a patient can easily access estimates and pricing information for services through an online patient portal, that can satisfy the No Surprises Act mandates. Or, when a provider updates a patient’s electronic health information (EHI) and the patient can readily access it and share it with another provider through that patient portal, this satisfies requirements of the Cures Act.
Enabling value-based care models
Driven by successes with the value-based care (VBC) model in medical health, payers have an increasing appetite for applying VBC to behavioral health. With the rapid uptake of virtual care during the pandemic, many organizations have discovered that telehealth offers an ideal and cost-effective way to achieve many of VBC’s goals. Virtual care can help companies reach more patients. It can help offset the industry’s persistent labor shortage by giving organizations more flexibility in scheduling. And it can enable providers to deliver comprehensive services that address all the needs of patients.
With a patient portal and telehealth solution integrated with your EHR, for example, you can offer services to patients at different times or days of the week, as well as reach patients who might not be able to attend in person. A virtual care solution can also extend what a patient learns during therapy sessions beyond clinic walls. For example, by connecting patients to peer coaches in recovery programs or delivering intensive case management programs, you can better support patients throughout their care journey.
Behavioral health organizations that adopt a VBC model may earn an early mover advantage. According to Behavioral Health Business, “Companies that are delivering high quality care and substantially better patient outcomes can negotiate for better reimbursement rates from payers.”
OnCall by Qualifacts helps behavioral health organizations build better insurer relationships
It’s clear that a comprehensive and integrated technology stack can unlock more productive relationships with insurers. It’s also evident that what’s good for insurers is good business for your behavioral health organization. Developing and launching new services can help your behavioral health company acquire mental health funding and coverage that was previously inaccessible.
When you integrate OnCall’s scalable, compliant virtual care software and secure online patient portal with your Qualifacts EHR platform, everyone wins. You give payers responsiveness to evolving policies, simplified operations and compliance for reduced costs, and expanded access to care. You give patients better experiences and outcomes. And your organization can grow to meet the needs of your patients with the highest quality of care.
It’s a win-win for insurance companies, patients, and your business.