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Corporate ReferralsCrisis Intervention ManagementPreferred EApInpatient PrecertificationPMHM Comprehensive Behavioral Management

Inpatient Precertification and Case Management

PMHM’s system of Professionally Guided Care SM ensures that each patient who is hospitalized receives the correct type and amount of inpatient treatment, as follows:

  • The facility representative contacts PMHM, first speaking to a Patient Relations Coordinator (PRC), who collects patient information and explains benefits.
  • The facility representative is transferred to the PMHM Psychologist who obtains the patient’s clinical history, diagnosis and list of current medications. PMHM’s Psychologist also obtains the facility’s treatment plan and estimated length of stay.
  • The PMHM Psychologist makes an initial authorization based on PMHM Clinical Criteria.
  • The PMHM Psychologist follows the patient’s progress throughout the stay, authorizing more inpatient days, if needed.
  • If PMHM manages the group’s outpatient benefits and arranges the patient’s treatment after discharge.

If you are interested in learning more about either of the above PMHM programs or if you would like to obtain a complementary behavioral cost analysis, contact PMHM.
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