spacer image
Menu Image
MBHP Online
FIND A PROVIDER
NEWS AND EVENTS
CONTACT US CAREERS AT MBHP HOME  
 
MBHP Employees
For Members link Para Miembros link For Providers link For PCC Providers link
SEARCH:
Spacer Image

PROVIDER MANUAL AND ALERTS
IMPORTANT CONTACTS
IVR AND EXTENSION SCREENS
ELECTRONIC CLAIMS
REPORTS AND SUPPORT MATERIALS
INFORMATION FOR PCCs
CARE MANAGEMENT SERVICES
CURRENT BENEFIT SERVICE GRID
CSA WORKING DOCUMENTS
PEFORMANCE INCENTIVE PROJECTS

Information for Primary Care Clinicians

The Primary Care Clinician (PCC) Plan Performance Improvement Management Services (PIMS) program is a comprehensive, clinically-focused management program that measures, monitors and improves the delivery of health care to PCC Plan Members. To support these objectives, PIMS provides PCCs with reports and information about services for members.

Performance Improvement Management Services assist PCCs by:
  • Providing a PCC Profile Report to PCCs who serve more than 180 PCC Plan members. This report tracks PCCs performance across several clinical areas, and provides data to allow the PCC to compare performance to other PCCs and to selected benchmarks.

  • Mailing a Reminder Report (RR) and a Care Monitoring Report (CMR) to all PCC Plan PCCs. These reports contain comprehensive lists of members who are overdue for preventive care.

  • Reviewing these performance-based reports every six months through face-to-face visits with PCCs who serve more than 180 PCC Plan Members. PIMS Regional Network Managers (RNMs) work collaboratively with PCCs to develop quality improvement goals suggested by the reports.

  • Conducting regionally-focused quality forums in clinical and administrative areas. These forums focus on improving the delivery of health care to PCC Plan Members.

  • Making available information and referral activities through the PCC Hotline, which is available to all PCC Plan PCCs regardless of their PCC Plan Member panel size.

  • Developing and distributing publications including a provider newsletter and a support materials catalogue.







Link SymbolMBHP is going Green!
 Effective April 8, 2010, notices of new routine authorizations, and the letters themselves, will be available at the MBHP/ValueOptions online provider portal ProviderConnect. Letters related to adverse actions or denials will continue to be sent through the mail. To hear a previously presented training on the authorization letter Go Green program click here.

Link SymbolChildren's Behavioral Health Initiative (CBHI)
 Please click here for information, including performance specifications, for the new Children's Behavioral Health Initiative (CBHI) services.

Link SymbolFile Electronic Claims
 Learn more about the advantages of submitting electronic claims.

Link SymbolRights for Your Clients
 Information on rights, appeals and grievances for your clients.

Link SymbolContact MBHP
 We're here to answer your questions and address your concerns.

 

 

 

MBHP - Massachusetts Behavioral Health Partnership
100 High Street 3rd Floor, Boston, MA 02110 : 1-800-495-0086
Privacy Policy - Terms and Conditions - Download Acrobat Reader
This page was last updated: 2/8/2010