Breaking Down Barriers: Addressing Utilization Review Challenges in Behavioral Health
Utilization review (UR) is designed to ensure appropriate care, but for behavioral health providers, it often becomes a major hurdle. Stricter scrutiny, delayed authorizations, and excessive documentation demands force providers to shift critical resources away from patient care, leading to financial and operational strain.
Kristina Colligan, Senior Vice President of Behavioral Health at Coronis Health, breaks down the growing burden of UR inefficiencies and how they impact treatment, revenue, and patient outcomes.
Key Takeaways:
- UR inefficiencies create financial and operational strain – Behavioral health providers face some of the highest denial rates, delaying care and costing millions in lost revenue.
- Automation and documentation standardization improve approvals – AI-driven tools and payer-specific workflows help minimize denials and accelerate reimbursement.
- Stronger payer collaboration reduces delays – Dedicated UR teams and real-time communication platforms enhance authorization processes and improve patient outcomes.
A Better Path Forward
These challenges are solvable. AI-driven automation, standardized documentation, and stronger payer collaboration can streamline UR, reduce denials, and improve cash flow. As technology advances, predictive analytics and real-time communication tools will further enhance efficiency, ensuring timely, necessary care while strengthening financial performance.
Read the full article to learn how your organization can take control of UR challenges and optimize financial stability.
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