Integrated Behavioral Health

Integrated Behavioral Health (IBH) implemented a K2-based solution to speed claims processing, improve customer service and increase efficiency.

As one of the leading managed-care providers of mental health services and employee assistance programs in the U.S., IBH services its 2 million members with a complete network of psychiatrists, psychologists, masters-level practitioners, hospitals, and outpatient facilities and programs. IBH receives and reviews requests for treatment from this entire network and handles the resulting volume of payment claims.

IBH manages this complexity by using K2 — in conjunction with Microsoft Office SharePoint Server 2007 and BlueThread’s SmartDesk software — to automate processes; to provide consistency and visibility; and to clean up what was once a complicated mess of paper, manual tasks, misrouted and misplaced documents.

IBH now processes most claims within 24 hours, and the company is exceeding service-level agreements with its members. Claim processing turnaround used to take more than four days.

IBH processes behavioral health and EAP (employee assistance program) claims for 25 Fortune 500 companies and 9,000 mid-to-small sized employers. It manages information for almost 2 million covered lives in the U.S. In competition with the country’s largest managed healthcare companies, IBH tries to differentiate itself by the service it provides to its employer groups and members. But manual claims-processing practices were getting in the way of company objectives.

IBH had large backlogs of work, rows of file cabinets filled with paper client charts, and the business was growing rapidly. A large portion of mailroom staff was dedicated to sorting mail and routing it to the appropriate claims processor or care manager. The processes were slow and inconsistent; on occasion, paper would be misplaced, leading to significant delays or other negative impacts on service.

The K2-based solution automated manual processes, aggregated IBH’s disparate systems, and allowed IBH employees to complete work and access content in a simple, graphical interface. Built-in rules and policies prevent mistakes, and K2 provides full visibility of the processes.

Now IBH receives, indexes, processes and completes payment claims quickly — usually within a day — confident of accuracy and quality. Calls are handled faster because information is immediately accessible.

Since deploying the solution, IBH has grown its core business by 50 percent with the addition of only two operational staff members. And because the system is so easy to use, training is fast.

“We can now track work in real time, increase accountability and reduce ‘noise for clients,’ ” said IBH President Ed Bosanac. “We can do all of this while improving service levels and use this message as a marketing tool to bring on new business. … The bottom line is that this (K2-based) solution improves IBH’s position in the marketplace.”