Behavioral Health Carve-Out
Human Behavior Institute (Human Behavior Institute) provides a full range of customized programs and services designed to manage mental health and substance abuse treatment across a continuum of care. We can tailor our clinical and operational systems to support a specific population, small or large employer groups, public sector organizations, union trust funds, or insurance plans. HBI's management decisions are based on a clinical rather than a business model.
Services can be offered as a comprehensive package, or they may be unbundled and carved-out individually. Human Behavior Institute offers the following behavioral health managed care solutions:
Human Behavior Institute offers full and partial risk capitated behavioral health, mental health, and substance use disorder treatment programs. From simple administrative services, network access, to full-risk models, Human Behavior Institute will assume all costs across the entire continuum of care.
Human Behavior Institute’s quality management begins from the time patients call the intake department for information and referral. Staffed with dedicated Intake Specialists whose sole function is to match members with the appropriate service and provider based on their demographic and preliminary clinical information, Human Behavior Institute also triages members and patients with potential high-risk cases, provides immediate crisis intervention by transferring the call to the supervising psychologist, verifies plan benefits and eligibility, and provides a referral to a staff model clinician, a network provider, or community services – all done on the initial call!
Human Behavior Institute’s provider network is one of the well-established and most qualified panels in the entire State of Nevada, including rural and underserved communities. Our panel members pass through Human Behavior Institute’s stringent credentialing process and criteria that exceed nationally-established standards. Human Behavior Institute’s Provider Network started in 1990 and initially provided services to the self-funded hotel industry. Soon after, in 1992 Human Behavior Institute became the preferred network to large insurance groups such as HUMANA, Anthem Blue Cross Blue Shield, self-funded plans, and other nationally-recognized insurance organizations.
Human Behavior Institute’s Utilization Management is URAC accredited and has maintained its highly-rated national accreditation since 2007 without interruption and adverse action. HBI's founder and president, Dr. Anis Abi-Karam, Ph.D. began performing Utilization Management (UM) in 1987 – at the time when managed care was at its infancy. Throughout the years, Human Behavior Institute has developed comprehensive UM procedures and protocols that adhere to high standards and best practices. Dr. Abi-Karam has provided consultations to major national insurance groups on establishing and implementing UM protocols. Human Behavior Institute’s Utilization Management adheres to NCQA and URAC standards and often exceeds guidelines established by these two accreditation bodies.
With over 20 years of experience, Human Behavior Institute’s Case Management is comprehensive and designed to manage and reduce mental healthcare costs without compromising services. It encompasses coordination between behavioral and medical healthcare in order to help the patient heal medically and psychiatrically. Patients are introduced and guided through the system until they are discharged from treatment.
Human Behavior Institute provides expedited assistance with claims processing for prompt and accurate payment. We provide claims mediation or processing via a third-party administrator. Human Behavior Institute regularly meets or exceeds industry standards for claims timeliness and accuracy.
Human Behavior Institute's Employee Assistance Programs are uniquely tailored to help members deal with their problems in the most appropriate and effective clinical setting possible. Human Behavior Institute views the individual as an integral part of his or her work environment. All Human Behavior Institute programs are designed to work with company supervisors, EAP counselors, benefits consultants, and/or personnel departments to develop optimal programs that best serve the needs of the company and their members. The program’s emphasis is not only on treating existing problems, but also on creating awareness and teaching skills that an employee can utilize to minimize and prevent serious emotional and physical health problems. In the long run, prevention is more cost effective than treatment alone.
Human Behavior Institute's Quality Improvement Program is the umbrella under which all review and monitoring activities are conducted. Human Behavior Institute’s entire activities are monitored by the Quality Improvement Committee which meets monthly to review policies, utilization, credentialing, complaints, and clinical services delivered by Human Behavior Institute and its network. Human Behavior Institute's Quality Management Committee members consist of: Behavioral Health Clinicians (Psychiatrists, Psychologists, Licensed Clinical Social Workers, and a General Practitioner M.D.), plan administrator representatives, behavioral health billing & office management representative, Provider Services Coordinator, and Certified UM-QM Nurse Practitioner.
Exceptional customized reports are prepared periodically and submitted in a presentation package for management reference illustrating actual data on quality management, utilization management, claims processing, and any other relevant information based on the managed care services above.