What We’re Hearing from Plans and Employers

  • Behavioral health access is constrained by “phantom networks.”
  • High‑cost inpatient and out‑of‑network claims are escalating.
  • Members struggle to navigate care across levels.
  • Employers face growing MHPAEA and compliance exposure.

Our Approach MINES actively manages behavioral health care rather than relying on passive networks—intervening early, coordinating care, and applying clinical and financial oversight throughout the episode of care.

Clinically Led, High‑Touch Model

  • Proactive utilization review (pre‑notification, concurrent, retro)
  • Early identification of high‑risk, high‑cost cases
  • Ongoing clinical case management and aftercare planning

Real Access, Not Just Network Logos

  • National PPO network is actively monitored for availability and fit
  • Rapid appointment scheduling and care navigation
  • Curated specialty panels for high‑stress and underserved populations

Cost Control with Accountability

  • Strategic claims repricing for behavioral health services
  • Flexible intake (EDI, 837, paper claims)
  • Strong QA processes and transparent reporting

Compliance & Risk Support

  • MHPAEA alignment support
  • Documentation and reporting that brokers and employers can use
  • Support for accreditation and quality initiatives

For many long‑standing self‑insured and managed care partners, this approach has resulted in:

  • Reduced paid behavioral health claims over time
  • Fewer member complaints related to access
  • Better coordination between outpatient, inpatient, and aftercare
  • Greater visibility into behavioral health utilization trends

We Partner With:

  • Self‑insured employers and captives
  • Health plans and ASOs
  • Brokers and TPAs
  • Public sector and Medicaid‑adjacent organizations

Ready to Talk Managed Care?

Whether access is tight, costs are spiking, or a population needs more responsive behavioral health support, we’re happy to compare approaches and provide solutions.

Managed Behavioral Health That Improves Access and Controls Cost

The Proof is in the Data

MINES’ clinical and operational approach delivers consistent, measurable results:

  • Average savings of approximately 59% off billed behavioral health charges, with typical ranges be-tween 40% and 65%, depending on population and utilization patterns
  • Significant reductions in member complaints related to access and care coordination
  • Claims repricing and processing accuracy exceeding 99%, supporting trust, compliance, and transparency

These outcomes reflect MINES’ ability to pair clinical excellence with operational precision, optimizing healthcare investments while improving the member experience.

A clinically led Managed Behavioral Health Organization (MBHO) delivering active utilization management, high-touch case management, PPO network access, and claims repricing—designed for employers, health plans, and brokers.

Connect with us to discuss your organization’s needs, evaluate opportunities for improvement, and design a solution that supports better outcomes for your members and your business.