Provider Services

Welcome to the Behavioral HealthCare Program’s (BHCP) provider home page. Our network includes licensed behavioral healthcare specialists, mental health centers, and hospitals. Our providers work collaboratively with BHCP to provide our members with quality behavioral health services. Your comments and suggestions are always welcome. 

If you are not a network provider and are interested in becoming a BHCP network provider, please contact us at 1-800-538-9698.

Access to Services

BHCP has toll-free telephone lines for access to services for members and providers. Utilization Management services are available 8am to 5pm each business day. The phones are answered 24 hours a day by clinicians for urgent member/provider calls. 

When a member calls the toll-free number they reach a call center representative who assists them with collecting the demographic information, reviewing benefits (for Martin's Point members) and searching for providers.   All requests for pre-certification of inpatient, partial hospital programs, and intensive outpatient programs are handled by the clinical case managers. 

Please click the following link for mental health and substance abuse resources for your members: /document/mental-health-and-substance-abuse-resources.docx

What a Clinician Can Expect

Clinician Rights & Responsibilities

  • You should expect to be treated with courtesy and fairness.
  • You should expect to be rewarded on the basis of merit and skill.
  • You should expect to receive fair and reasonable fees for your work, and receive them promptly.
  • You should expect your paperwork and telephone calls to be kept to a minimum.
  • You should expect to receive clear and understandable communications from you third party administrator.
  • You should expect to have a source of consultation and referral for your patients who need this.
  • You should expect any system of which you are a part to hear and welcome your suggestions.
  • You should expect change if change will solve a problem rather than create a new one.

BHCP's Accessibility Standards:

BHCP providers should direct members to the ER for emergent care needs. 

 

 

Accessibility Standard Performance Goal
Average speed of telephone answer: 30 seconds or less.
Telephone call abandonment rate: 5% or less.
Percentage of telephone calls handled within 30 seconds: 85%
Appointment offered with non- life threatening emergency care needs: 99% within 6 hours
Prescriber behavioral health urgent appointments: 60% of offices report a first available urgent appointment is open for a patient within 48 hours of patient request
Prescriber behavioral health new patient routine appointments: 60% of offices report a third available routine appointment is open for a new patient within 10 business days of patient request
Prescriber behavioral health established patient routine follow-up appointments: 60% of offices report a third available routine appointment is open for an established patient within 60 days of patient request
Non prescriber behavioral health urgent appointments: 85% of offices report a first available urgent appointment is open for a patient within 48 hours of patient request
Non prescriber behavioral health new patient routine appointments: 85% of offices report a third available routine appointment is open for a new patient within 10 business days of patient request
Non prescriber behavioral health established patient routine follow-up appointments: 85% of offices report a third available routine appointment is open for an established patient within 60 days of patient request
 

Grievances:

As a network BHCP provider, should you become aware of a member concern or complaint that cannot be resolved quickly or satisfactorily, or which involves a health plan, you will advise the member that a formal grievance may be filed by calling the applicable member services or grievances contact number for the relevant health plan.

Serious Reportable Event:  

Immediately upon becoming aware of a Sentinel or Serious Reportable Event, as a BHCP network provider you will notify the relevant health plan of the event by contacting such plan’s risk management department (or other department as instructed by such health plan).  Sentinel Events are those events defined by The Joint Commission as Sentinel Events. Serious Reportable Events are those events defined by the National Quality Forum as Serious Reportable Events.


 

Forms & Documents