The Holman Group, an innovator in the behavioral health care industry, has managed care for over 500,000 members for Medicaid, Medicare and commercial partners nationwide for over 42 years. Holman is dedicated to providing top quality services and effective cost control through early problem identification and resolution, clinical excellence, superb quality management and customer-focused service. Knox-Keene licensed in CA since 1985 and URAC accredited since 2015, Holman holds the Credentials Verification Organization (CVO) and Utilization Management (UM) and Health Network (HN) accreditations through URAC. To stay current with developing legislation and national trends, Holman is an active member of CAHP, NAHU, EAPA and SHRM.
Mental Health / Substance Use Services Program Inclusion
- Live Person First Answer – Includes a toll-free line open 24/7, 365 days a year. All of our calls are answered by a live specialist and are not relayed through a confusing, automated system. Our care access team understands how difficult that first call can be, and will caringly help your members reach the right service, triage to licensed counselors, understand their benefit package or get them to the correct level of care.
- Network Management – Holman has a dynamic nationwide network of over 15,000 licensed clinicians and facilities nationwide. The Holman network is constantly evolving to meet the needs of our clients, which includes education, peer support, enhancement, credentialing, recredentialing and monitoring network accessibility for members on an ongoing basis. We can enhance our network to meet your access and specialty needs to assist in member access to care.
- Provider/Facility Network-Included in our network: Registered Master’s and PhD Associates, Autism and ABA providers, licensed Master’s and PhD, NP, PA, NP, MD, DO. Intensive Outpatient (IOP), Partial Hospital (PHP), Residential Treatment Centers (RTC), Inpatient Hospital stays and Acute Hospital Detox.
- Claims Payment – Holman can process or reprice claims through an 837 electronic claims file, according to the benefit of the plan (with the client funding a claims trust account for Holman to pay on their behalf) or sending them on to an MSO or TPA for payment.
- Utilization Review and Case Management- Members call into Holman to discuss going into a facility or higher level of care with one of our dedicated inpatient licensed care managers. We also conduct retrospective reviews and provide assistance for emergency admits 24/7/365. Working with your care managers, each member, their family, provider and/or facility to help determine the most effective treatment plan with the best outcome. Assessment, planning, facilitating care, evaluation and advocating for the member using a combined medical and social work model. Holman uses a combination of our Medical Director/psychiatrist, the licensed case manager, peer review with the facility and Change Healthcare decision support software (where applicable), or CA Mental Health Parity compliant medical necessity criteria to assist in providing the best outcome for our members.
- Utilization Reporting- Providing monthly, quarterly and annual reports on utilization or as needed.
- Eligibility, Coordination of Benefits & PCP Referrals- Holman has access to your portal eligibility files and updates for members and partners, facilitates services through PCP referrals and coordination of benefits is facilitated at the time the claim is paid (based on whether your coverage is primary or secondary).
- Dedicated Account Management – To ensure that our members receive the highest quality of care, Holman’s comprehensive quality management program measures the performance of our benefits and network providers, including after-treatment satisfaction surveys, report cards and regular reviews on departments and providers.
- Customized Implementation - Upon selection of Holman as your mental health/substance use program, your Holman implementation team will work with you and your staff to identify key electronic promotion and communication strategies.
Contact the Holman Sales Department for a Quote: