BHM Healthcare Solutions

BHM Healthcare Solutions BHM promises to meet or exceed client requested turnaround times and deliver accurate results.

Behavioral Health and Medical Review Experts

Providing behavioral health and medical review services and performance improvement consulting to health plans, providers, ACOs, TPAs, workers' compensation and other insurers nationally.

📢 CMS has released new guidance on Medicaid state-directed payments (SDPs), adding stronger oversight and accountability...
09/11/2025

📢 CMS has released new guidance on Medicaid state-directed payments (SDPs), adding stronger oversight and accountability measures.

The update emphasizes transparency, documentation, and quality outcomes, ensuring financing and distribution align with value-based care. This shift means payers, providers, and states should prepare for enhanced monitoring and reporting requirements.

CMS issued new guidance tightening oversight of Medicaid state-directed payments, requiring stronger documentation, transparency, and more.

💛 Childhood cancer impacts thousands of families every year. By raising awareness, we can drive progress in early detect...
09/11/2025

💛 Childhood cancer impacts thousands of families every year. By raising awareness, we can drive progress in early detection, improve treatment options, and strengthen support systems for children and their loved ones.

Our latest article explores innovations and holistic care strategies that bring hope to young patients and their families.

Support Childhood Cancer Awareness Month by learning how to improve outcomes for young patients and their families.

CMS price transparency rules sound simple: publish the files, make costs clear. But for payers, the real challenge lies ...
09/09/2025

CMS price transparency rules sound simple: publish the files, make costs clear. But for payers, the real challenge lies in disclosure. Even small mismatches between hospital and plan data can trigger member frustration, provider disputes, and compliance risk.

👉 In our latest article, we break down what CMS actually expects, why disclosures matter, and where payers face the most risk.

Explore the CMS disclosure requirements driving payer risk and compliance exposure. And how to align governance, vendors, and validation before penalties.

Su***de is a serious public health issue that affects countless families and communities. Healthcare providers are on th...
09/04/2025

Su***de is a serious public health issue that affects countless families and communities. Healthcare providers are on the front lines, uniquely positioned to identify at-risk patients and provide the timely support they need. With effective screening and intervention strategies, lives can be saved.

Let’s continue breaking the stigma and spreading awareness. Early intervention truly matters. 💙

***dePrevention

Discover evidence-based screening protocols and intervention strategies for su***de prevention in healthcare settings.

📢 The final rule from HHS delivers real-time prescription drug price transparency at the point of care. With certified h...
09/03/2025

📢 The final rule from HHS delivers real-time prescription drug price transparency at the point of care. With certified health IT, you’ll gain instant visibility into patient-specific coverage, out-of-pocket costs, and prior authorization requirements.

The result? Reduced administrative burden, faster access to therapy, and smarter prescribing decisions that align with value-based care.

HHS finalized a rule to expand real-time prescription drug price transparency and electronic prior authorization through certified health IT.

Healthcare price transparency isn’t just a regulation; it’s an opportunity. With penalties reaching $5,500/day, complian...
09/02/2025

Healthcare price transparency isn’t just a regulation; it’s an opportunity. With penalties reaching $5,500/day, compliance is critical, but it also builds patient trust, reduces surprise billing, and strengthens your competitive edge.

Our latest article breaks down the key rules, requirements, and penalties you need to know, plus how the right vendor support can simplify compliance.

Discover how the Price Transparency Act impacts hospitals, insurers, and patients. Learn compliance steps, penalties, and solutions for 2025.

🍂 Fall is right around the corner and so is flu season. Healthcare organizations that prepare early can better protect h...
08/28/2025

🍂 Fall is right around the corner and so is flu season. Healthcare organizations that prepare early can better protect high-risk populations and keep their communities healthy. ✅

Check out this article for strategies to make your flu vaccination campaigns more effective this year. 💉

Prepare for the fall flu season by planning early vaccination campaigns. This guide offers strategies for focusing on high-risk populations.

Gold carding helps healthcare providers focus more on patients and less on paperwork. By reducing prior authorization re...
08/26/2025

Gold carding helps healthcare providers focus more on patients and less on paperwork. By reducing prior authorization requirements for trusted providers, it streamlines approvals, cuts down on administrative burden, and rewards consistent, high-quality care.

Explore how gold carding reduces the burden of prior authorization for healthcare providers by rewarding consistent, guideline-adherent care.

📢 HHS is forming a new Healthcare Advisory Committee to advise on Medicare, Medicaid, and other federal health programs....
08/21/2025

📢 HHS is forming a new Healthcare Advisory Committee to advise on Medicare, Medicaid, and other federal health programs. Focus areas include chronic disease prevention, reducing administrative burden, real-time data modernization, Medicaid quality, and Medicare Advantage sustainability.

Nominations are due September 21, 2025. Learn more in our latest Industry Watch Alert.

HHS announces a new Healthcare Advisory Committee and calls for nominations by September 21, 2025, to advise on data-driven improvements.

Immunization saves lives, but not everyone has equal access to vaccines. Many underserved communities face barriers that...
08/21/2025

Immunization saves lives, but not everyone has equal access to vaccines. Many underserved communities face barriers that put their health at risk. By supporting targeted immunization initiatives and encouraging collaboration between payers and providers, we can help close these gaps and protect vulnerable populations. 💉🌍

Explore targeted immunization initiatives aimed at closing vaccination gaps in underserved populations, emphasizing the importance of payer and provider collaboration.

Say goodbye to long phone calls and fax machines. 📞➡️💻 Electronic prior authorization (ePA) makes it easier for provider...
08/19/2025

Say goodbye to long phone calls and fax machines. 📞➡️💻 Electronic prior authorization (ePA) makes it easier for providers to get approvals for treatments and prescriptions.

It's faster, simpler, and more reliable. That means less admin work for providers and quicker access to care for patients.

Learn how electronic prior authorization (ePA) transforms healthcare by replacing manual workflows, improving provider experience, and supporting FHIR API compliance.

Vaccine hesitancy continues to challenge public health goals.By listening to concerns, addressing misinformation, and fo...
08/14/2025

Vaccine hesitancy continues to challenge public health goals.

By listening to concerns, addressing misinformation, and fostering trust, we can encourage more people to protect themselves and their communities. Learn how evidence-based strategies are making a difference.

Explore effective strategies to combat vaccine hesitancy through clear communication and community engagement initiatives.

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