Behavioral Health

Behavioral Health Tailored Solutions to Optimize Operations.

Toney Healthcare brings dedicated clinical operations teams and advisory services to health plans and other risk-bearing organizations, supporting the seamless implementation, integration, management, staffing and growth of critical behavioral health programs. Leveraging best-practice expertise spanning local, regional and national levels, we support behavioral health initiatives across all plan types and lines of business, helping organizations stay compliant, enhance operational efficiency and deliver high-quality behavioral health services.

EXPERT GUIDANCE TO INTEGRATE AND OPTIMIZE BEHAVIORAL HEALTH PROGRAMS

Our advisory services dive deep into integrating behavioral health with your medical management strategy. We work with you to identify the right services and operationalize your behavioral health programs with the systems, policies, workflows, metrics, and staffing to ensure optimal quality performance. We’ll also help you build the network you need to meet the needs of your members.

SKILLED RESOURCES. QUICK ACTIVATION.

Our expert resources can be quickly deployed—as individual resources or complete teams—to manage your clinical behavioral health operations. We are fully trained in all aspects of behavioral health management. Whether you need case and utilization management, specialized behavioral health programs, or social outreach and support, our experienced professionals will help you enhance operational and quality performance, without the hiring burden. All we need is training on your systems to get started, ensuring full productivity and transparency from day one.

Advisory Services

Behavioral health integration with medical management to remove siloes and improve collaboration across interdisciplinary team

Quality performance improvement, data analysis, and reporting aligned with NCQA, CMS, URAC and other regulatory requirements plus audit and accreditation support

Process optimization and tool alignment to improve efficiency, save costs, and support best practices and compliance

Behavioral health network development and relationship management including contracting, reimbursement and participation requirements

Curriculum development and training

Operational Execution

  • Expert behavioral health case and utilization management

  • Specialty programs such as substance use disorder, ABA management/autism

  • Pharmacy reviews and pharmacy benefit manager coverage

  • Mental health parity with NQTL assessment, remediation, and development, compliance, analyses, legal guidance, and submission support

  • Claims adjudication and payment integrity

  • Social outreach and support

Sampling of Past Behavioral Health Project

  • Sampling of Past Behavioral Health Projects Behavioral health utilization management services for multi-state Medicaid plan

  • Behavioral health integration project for Medicaid/dual-eligible plan in northeast

  • Behavioral health integration strategy and implementation advisory services for large Medicaid plan in Texas

  • Behavioral health medical director/physician review services (psychiatrist) for multiple health plans across lines of business

  • VP of Behavioral Health Care Management for Medicaid/Tailored Plan in North Carolina

Ready to learn more?

Toney Healthcare’s team of experts is ready to help you address your behavioral health program requirements with advisory services and plug-and-play health management resources so you get the help you need, fast—and without HR headaches.

Toney Healthcare’s team of experts is ready to help you address your utilization, care and behavioral health resource needs with plug-and-play health management services and expertise so you get the help you need, fast—and without HR headaches.

Toney Healthcare Overview