The CriteriaIQ blog is a set of practical guides to behavioral health utilization review, prior authorization, and denial management. Articles are written by Steven Cavan, who has worked in utilization review since 2012.
Learn how all-in-one behavioral health RCM software reduces insurance denials through automated utilization review, prior authorization tracking, and denial management.
Read article →A complete guide to utilization review software for behavioral health facilities — ASAM criteria, concurrent review, peer-to-peer management, and appeal tracking.
Read article →Everything behavioral health RCM managers need to know about prior authorization — from initial submission to concurrent review and appeals.
Read article →How to build an effective behavioral health denial management process — tracking denials, filing appeals, and using clinical criteria to overturn decisions.
Read article →How ASAM 4th Edition criteria map to insurance authorization requirements for residential, PHP, and IOP levels of care.
Read article →How integrating Kipu EMR with your RCM platform eliminates manual data entry, reduces errors, and speeds up authorization workflows.
Read article →How to conduct accurate verification of benefits for behavioral health admissions — what to check, common pitfalls, and how software automates the process.
Read article →How to prepare for and win peer-to-peer reviews with insurance medical directors — clinical arguments, documentation tips, and tracking outcomes.
Read article →How behavioral health facilities manage concurrent review — tracking review dates, submitting clinical updates, and preventing coverage gaps.
Read article →The 10 must-have features in a behavioral health RCM platform — from authorization tracking and VOB to clearinghouse integration and analytics.
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