We know your company’s behavioral health care needs are unique.
contact PMHM at 800-776-4357.
(Outpatient & Inpatient Behavioral Management)
For the ultimate in treatment quality and cost effectiveness, PMHM Comprehensive is a full behavioral managed care program for both outpatient and inpatient care. PMHM Comprehensive includes the following:
Outpatient Assessment & Referral
When a member requires services, he or she calls PMHM’s toll free helpline. The helpline is manned 24 hours a day and 7 days a week. During the call, the patient initially speaks with a PMHM Patient Relations Coordinator (PRC) who explains the benefits and how the referral process works. The patient is then transferred to a PMHM Staff Psychologist who conducts an initial assessment to determine:
- Why the patient called PMHM
- Nature and scope of problem
- History of the problem
- Patient’s mental status and psychiatric history (if applicable)
- Drug/alcohol use and history (if applicable)
- Patient’s medical condition
- Any special patient needs
During this call, the PMHM Psychologist refers the patient to a Network Provider in his or her area for a specific number of treatment visits. After the call, the PRC enters the patient’s information into PMHM’s Referral System and Treatment Authorization letters are generated for both the patient and the Provider. The Treatment Authorization specifies the Network Provider, the treatment being authorized and a specified number of sessions. For the patient to receive more care, the Provider must complete a Treatment Extension Authorization Request.
Authorization for outpatient treatment is made in keeping with benefit plan requirements and PMHM’s Clinical Protocols.
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, after discharge, the patient’s outpatient treatment is arranged.
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.
PMHM’s Preferred EAP program is designed to provide confidential, professional assistance to employees before personal or family problems impact work performance. PMHM offers telephonic or face-to-face EAP sessions, depending on the employer’s requirements.When a covered member calls the EAP help line, a doctorate level PMHM Staff Psychologist conducts a telephone assessment to determine the type and amount of service needed. The PMHM Staff Psychologist assists the employee in:
- Clarifying the problem
- Dealing with any crisis situations
- Accessing appropriate community resources
- Identifying a treatment professional in the community for a face-to-face EAP session, if required
- Authorizing mental health or substance abuse treatment through the company’s health insurance plan if necessary
What Kinds of Problems Does the Preferred EAP address?
The Preferred EAP can address any problem that is occupying an employee’s time and attention and creating stress in his or her life. Some typical problems or issues people may have include:
- Child care concerns
- Elder care issues
- Parenting issues
- Debt or money management
- Marital problems or divorce
- Workplace conflicts
- Death of a loved one
- Legal issues
Members may call PMHM’s toll free number for confidential assistance.
Counseling through the Preferred EAP is at no cost to the employee. After accessing services through the Preferred EAP, the employee may be referred to a mental health specialist for continuing mental health or substance abuse treatment. These services are generally covered under the employee’s health insurance benefit and may involve a copayment, deductible or co-insurance payment.
Preferred EAP services do not include psychological testing or psychiatric care. When these services are needed, the PMHM Staff Psychologist refers the patient for treatment with a Network Provider which is often reimbursable by insurance.
To find out how the Preferred EAP Program may benefit your company, contact PMHM.
Preferred Mental Health Management (PMHM) offers the Crisis Intervention Program for employers with multiple locations which are subject to robberies or other high-stress events.This program includes providing locations which experience a critical event with consultation and/or a workplace intervention. This intervention is designed to ease the effects of the critical incident and accelerate the recovery process. The most common intervention is a Critical Incident Stress Debriefing (CISD). A CISD is a group intervention which is held two to five days following the critical event for everyone directly involved who may be affected by the stress. The CISD is conducted by a mental health professional who has had advanced training in working with this type of problem. CISDs emphasize openly communicating feelings and reactions, mutual support and learning stress management techniques.
In addition to the group CISD session, individual counseling may be recommended for employees who are having an especially hard time coping with the stressful event.
While employees usually recover from the crisis over time without intervention, a CISD speeds up the process. As a result, employees return to work more quickly and function at a higher level. Job turnover due to the critical event tends to be reduced when a crisis intervention is provided.
PMHM’s Crisis Intervention Services include:
- Arrangement of an On-Site Critical Incident Stress Debriefing Session. PMHM will arrange for one or more providers, who are trained in CISD, to conduct an onsite CISD session with employees directly affected by the event.
- Referral to a Local PPO Counselor. A PMHM Staff Psychologist can arrange for a referral to a local network provider for individuals who require more intensive counseling in order to cope with a crisis.
- 24 Hour Telephone Crisis Intervention with a PMHM Staff Psychologist.
PMHM offers 24 hour telephone crisis intervention counseling with a Staff Psychologist for any employee during an emergency. Managers may also call to discuss their concerns during a crisis.
BENEFITS OF A CISD INTERVENTION
The company’s staff benefits from a CISD because it:
- Reduces stress and feelings of isolation and abnormality resulting from the Critical Incident.
- Prevents the onset of delayed psychological reactions and promotes well-being.
- Provides peer support and education about stress reactions.
- Improves coping skills for future incidents.
If you are interested in learning more about how a Critical Incident Management Program may benefit your company, contact PMHM.
contact PMHM at 800-776-4357.
With the daily challenges faced by every employer, there is little time to handle issues such as absenteeism, substance abuse and poor work performance. PMHM offers the Corporate Referral Program as an alternative to terminating a problem employee.
A Corporate Referral is a mandatory referral for employees who exhibit poor job performance due to personal or work-related problems. PMHM provides assessment and referral for the employee and helpful assistance to the employee’s supervisor. The PMHM Staff Psychologist refers the employee into treatment with a local provider, establishes treatment goals, and monitors the employee’s care. Treatment Progress Reports are provided to the supervisor throughout treatment.
- fail a company drug or alcohol screen
- be discovered using alcohol or drugs on the job
- appear “high” or intoxicated at work
- have sexual harassment issues
- exhibit abusive behavior on the job
- make actual or implied threats to self or others
- be aggressive on the job
- exhibit poor job performance due to extreme stress (divorce, death of a loved one, financial problems, etc.)
Once the company is enrolled in the Corporate Referral Program, PMHM sends referral packets to the HR Department to keep on hand until the need arises. Once the company has determined an employee needs a Corporate Referral, the company takes the next steps:
- Have the employee Sign a Waiver of Confidentiality. The employer then emails this waiver to PMHM prior to calling the Help Line. The waiver allows the company representative to discuss the employee’s problem with PMHM.
- The employer has the employee call PMHM.
- The employee calls PMHM and speaks with a Patient Relations Coordinator (PRC), who obtains basic information before transferring the employee to a PMHM Staff Psychologist. After speaking with the employee about the problem, the Psychologist refers the employee to a provider in his or her area.
- After receiving the name and phone number of the provider, the employee must schedule his or her first appointment by the end of the next business day.
- The employee is provided with Progress Forms which must be taken to each counseling session. After each session, the provider completes the form and sends one copy to PMHM. The employee returns the other copy to the company representative.
- PMHM follows the employee’s counseling session attendance and progress throughout treatment, continually keeping the employer informed.
If you are interested in learning more about how a Corporate Referral Program may benefit your company, contact PMHM.