How Behavioral Health Roundtable Consultation Can Work for You
July 26, 2017
At R3 Continuum, we spend a lot of time thinking about how to help solve our customers’ problems. This is not the same as offering an array of services. We do, of course, but only those services that we know help solve a specific problem. It is a collaborative and engaged process. One such service was borne out of a common customer problem; “we don’t have enough behavioral health expertise on our team…how do we effectively and accurately manage behavioral health claims?” We came up with an answer; one that is simple, efficient, and cost-effective: behavioral health roundtable consultation.
Behavioral health roundtable consultation is not new in concept, but we have seen great results using it to help examiners and assessors better manage, make decisions on, and increase comfort level with behavioral health claims at any stage (pre-claim, initial claim, short-term, long-term, and the all-important return to work). Quite simply, it is placing a behavioral health expert in the room (via phone, telepresence or in person) to help assess and guide a claim. Doing so has several benefits:
1. It allows for clinical input on several cases in a short period of time: A one-hour consultation may involve discussion of as many as 5-6 cases. By bringing questions to the table, we can help move a case forward in a matter of minutes, rather than days or weeks.
2. It is cost-effective: Being able to discuss multiple cases in an hour, is the most efficient way to get good clinical input at a reasonable cost. It also prevents premature or unnecessary IMEs, peer reviews, or other services. While those services are often needed and important, doing one too soon or before all the necessary data is available can result in a minimally useful evaluation. Roundtable consultancy can help fill in the gaps and make the most appropriate service request. Getting an IME or peer review right the first time is not only more cost-effective but the fairest and most appropriate for the claimant’s we serve.
3. It is timely: In the fast-moving world of claims, we know it is important to process claims quickly and fairly. By being able to bring cases at any stage, in a more informal way, we can address claims in a timely manner and help ensure that each claim is moving forward, with the right clinical input.
4. It trains your team: Roundtable consultancy is truly about making your team better. The most important part is the learning from cases and issues that can then be applied to future cases. As we practice and internalize what we practice, we become better. There are always going to be some cases that truly need high-level clinical input, but the improved skill set will help to bring only those cases where the high-level clinical input is needed.
Nobody can be an expert in every area of work absence management. R3 is, however, an expert in behavioral health absence management. Your team are experts in claims management. By placing our clinical expertise with your team, we believe we can help achieve the critical balance between time, money, and clinical accuracy.