Behavioral Health Partners (BHP) is a mental health services organization with a BJC HealthCare contract to provide managed mental health service to health plan members throughout Missouri and select areas of Illinois.

Utilization Management
BHP's Utilization Management (UM) monitors and evaluates:

• Clinical necessity
• Appropriateness
• Efficacy and efficiency of services
• Procedures
• Level of care

UM coordinates services to:

• Promote health and wellness
• Maximize independence and resources
• Support members in their recovery

UM includes:

• Medical necessity review for proposed or concurrent care
• Help in determining benefit eligibility
• Monitoring, evaluation and management of costs
• Preauthorization of planned inpatient admissions
• Referrals to specialists
• Partial hospitalization/day treatment and intensive outpatient

Quality Assurance
BHP's Quality Improvement Program ensures that members receive quality behavioral health care. The Program evaluates providers and monitors:

• Quality of care
• Efficiency of care
• Member satisfaction
• Fulfillment with administrative requirements
• Compliance with clinical standards

Credentialing
BHP screens each network provider to ensure quality assessment standards. Providers are subject to initial credentialing, which closely evaluates their professional training and education, and identifies the range of behavioral health services they are qualified to render. Practitioners participate in a quality appropriateness and peer-review process every two years.