Managed Behavioral Health Organization

Population Health Management Software for MBHOs

SmartCare™ assures value-based outcomes for your Managed Behavioral Health Organization

Managed behavioral health organizations (MBHOs) are responsible for the overall view of the client—to coordinate treatment and help achieve better outcomes. The clients you serve are provided treatment based on evidence-based principles through performance measurements and standards of care.

The SmartCare™ MBHO platform provides a web-based managed care application that provides an extensive and flexible integrated solution for MBHOs as they are more and more responsible for assuring value based outcomes.

The MCO functionality of SmartCare™ gives your organization powerful convenience:

1. Process claims from your provider network

2. Give your providers direct access to the system

3. Manage members’ information

4. Experience robust reporting capabilities

SmartCare™ is an integrated module designed to help MBHOs manage, communicate, collaborate with and pay their external service providers.

SmartCare™ is the only application on the market that is not limited to just tracking and coordinating services among providers, but is a complete integrated record where your staff can truly become part of the care management team; providing and tracking services for a more holistic collective care plan and coordination workflows.

As you increasingly incorporate risk-based contracting with your provider networks, population health outcomes require a complete platform of care solution that offers your organization complete flexibility.

How does SmartCare™ help achieve value-based outcomes?

The SmartCare™ Dashboard gives easy access to:

  • Members’ current medical and billing status – 12 month plan
  • Overview of all claims by current status
  • Scheduled Events (hospitalizations, discharges etc.)
  • Alerts and Messages, e.g. when a provider’s contract reaches its cap

Easily track and report on your most important metrics:

  • Authorization tracking
  • Hospitalization pre-screens
  • Hospitalization concurrent reviews
  • Hospitalization discharges
  • Capitated plan management

SmartCare™ also provides you with tools to document UM review of authorizations, and justification for approved services which meet URAC standards.

Strengthen your organization by empowering your providers

  • Access to member demographics and member eligibility
  • Access to authorization tracking 
  • The ability to complete services & upload claims
  • The ability to generate payment reports

Streamline your Claims Processing

  • Receive 837 Electronic Claims
  • Adjudication Processing
  • Payment, Check Processing and RA Distribution
  • Refund and Credit Management
  • RA/835 Distribution
  • Integrated Payment and/or GL system

Easily manage your providers

  • Contracts and rates
  • Credentialing
  • Site review
  • Provider search for member referral

Manage your organization’s members

  • Demographics
  • Plan eligibility
  • Hospitalization tracking
  • Scan/upload or directly enter required information

How can SmartCare™ help your MBHO? 

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  • SmartCare is built to be the most intuitive application for the health and human services market. This first review will cover navigation of our integrated clinical and billing system, and any specific topics you have listed below.

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