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Upgrade to an Integrated End-to-End System for Behavioral Health Management

Improve behavioral health delivery by combining all the required management functions of your state agency or managed care organization onto one powerful platform. Connect the entire continuum of business processes, and benefit from seamless integration across enrollee management, provider networking, care coordination, utilization management, and claims cycle management.

Automate Medicaid waivers

Managing Medicaid waivers for behavioral health can require multiple resources. However, you can automate many manual processes globally while maintaining the flexibility needed to ensure that each waiver managed meets the funding requirements.

  • Provide funders with a complete cross-agency view of the person being served, whether enrolled in a single program or multiple programs
  • Prioritize waitlists based on criticality of need
  • Keep the focus on your consumers by tracking and monitoring person-centered plans
  • Collect insights and help ensure accurate payments with our sophisticated financial and claims management tools
  • Improve care and stay in compliance by documenting and tracking all incidents and grievances

Promote comprehensive care coordination

Coordinate the care of high-risk individuals through automated alerts and the ability to track progress from authorization through service claims.

  • Monitor the true level of service delivery and utilization rates of authorized services
  • Track the efficacy of person-centered plans against utilization of high-cost, high-level services
  • Improve efficiency through the electronic submission and tracking of person-centered treatment plans and service authorization requests.
  • Coordinate communication of plans to service provider networks

Make informed decisions with real-time business intelligence

Take advantage of the information you capture in your daily business processes. Use your data to gain valuable insights about the individuals being served, the health of your provider network, and your overall program effectiveness. AlphaMCS provides standard system reports in functional areas as well as a replicated database with access to data tables for ad hoc reporting.

  • Run standard system reports that capture the status of the data based on current transactions
  • Design your own dashboards and reports to meet your specific reporting needs
  • Answer almost any question you have about your operations with an easy-to-use data warehouse tool that contains more than 130 dimensions and 220 measures

Improve your network management and provider communication

Success in risk management and optimizing both provider and client outcomes begins with great coordination and communication. As you strive to work more closely with your providers, Mediware can provide you with the tools you need for success.

  • Manage your network provider demographics, sites, services provided, NPIs, taxonomies, contract limits, and negotiated rates
  • Automate grievance, complaint, and compliment tracking and resolutions
  • Enhance provider communication with a full-featured provider portal
  • Capture and track both provider and client outcomes to ensure care is being provided in the most effective and efficient way to minimize risk and maximize individual potential

Partner with a company that knows and meets the needs of both payers and providers

Mediware’s combined experience and expertise across the continuum of the human and social services market is unparalleled, and our products, managing both provider and payer requirements and responsibilities, seamlessly integrate. Mediware has the knowledge and skill required to design, develop, and implement successful provider, payer, and manager products in multiple markets, with current deployments in mental health, substance use, intellectual and developmental disabilities, homeless care, and aging and eldercare.

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