Your hardest patients to reach are covered. We do the reaching.
Behavioral health is a covered benefit for your Medicare and Medicaid patients. The barrier was never the benefit. It is that somebody has to find these patients, keep calling them, treat them, and close the loop, and that somebody has always been your staff. Integral Health takes all of it.
- We do the outreach, in the patient's own language
- We close the behavioral health quality gaps
- We are the referral partner you cannot find
- No hire, no new system, no upfront cost to the practice
The coverage was never the problem.
Practices do not lose these patients because the benefit is missing. They lose them because engaging a Medicaid panel is relentless work that no primary care office is staffed to do.
Numbers change, voicemail is full, and the visit was three months ago. Your staff burns hours on calls that go nowhere.
The therapists with openings do not accept Medicaid, and the ones who do are not taking new patients.
Screening, follow-up after a positive screen, follow-up after an emergency visit. Every one of them requires the patient to actually engage.
The untreated anxiety or depression resurfaces as a crisis, an admission, and a discharge nobody follows up on.
This is the work your staff is doing today.
A single enrollment can take five contact attempts across two channels and three days. Multiply that by a panel and you have a full-time job nobody was hired for.
Getting a Medicaid patient on the phone is the whole job. It is our job.
- Day 0, 10:12CallNo answer, no voicemail set up
- Day 0, 10:14TextSent in the patient's preferred language
- Day 1, 17:40CallAfter work hours, voicemail left
- Day 2, 12:05TextReply received, callback requested
- Day 2, 16:20CallReached. First appointment booked for Thursday
The behavioral health measures you are graded on, closed for you.
Every behavioral health quality measure has the same failure point. It is not the clinical decision. It is whether anybody managed to reach the patient and keep them in treatment long enough to count.
Every one of these fails for the same reason: somebody has to reach a patient who is hard to reach, and keep reaching them. That is the part we take.
Who does what, from flag to follow-up.
The honest version of the division of labor. Two steps sit with you. The rest is ours.
The patient is found
Nightingale sweeps the panel and flags who is deteriorating, with the reason attached. Nobody reviews charts by hand.
You see one flag
It appears in the chart you are already in. No second system, no new login.
We reach the patient
A behavioral care manager calls within about 48 hours, in the patient's own language, and keeps calling until they answer.
They are seen in days
First appointment inside your practice, not a waitlist at a clinic across town.
Treatment is tracked and adjusted
PHQ-9 and GAD-7 every visit. A consulting psychiatrist reviews the whole caseload weekly and advises on medication.
You get the answer back
The trend, the recommendation, and the note land in the chart. You stay the prescriber and stay in the loop.
They graduate, or we escalate
Patients exit with documentation and a follow-up plan. The ones who are not improving get changed, not closed.
What the care team works from.
You do not have to live in this. It is where your care manager finds the patients who are slipping, so the only thing that reaches you is the answer.
| Patient | Program | PHQ-9 | GAD-7 | Last contact | Status |
|---|---|---|---|---|---|
| Louise M. | CoCM | 14 → 8 | 11 → 6 | 2 days | Titrate |
| James O. | CoCM | 9 → 4 | 8 → 5 | 5 days | On target |
| Priya S. | BHI | 16 → 15 | 12 → 11 | 12 days | Follow up |
| Wei C. | CoCM | 12 → 5 | 9 → 4 | 3 days | On target |
| Dana R. | CoCM | 7 → 3 | 6 → 3 | 6 days | On target |
What physicians ask first.
Is this covered for Medicaid patients?
Collaborative care is a covered, billable service under Medicare nationally, and Medicaid coverage continues to expand state by state. We confirm coverage for your payer mix before anything starts.
Who does the outreach?
We do. Behavioral care managers make the calls and send the texts, in the patient's own language. Nothing about the outreach falls on your front desk.
What actually changes in my day?
You read a flag in the chart, and later you read a note with the patient's scores and the psychiatric recommendation. That is the whole ask.
Do I need to hire anyone?
No. The care managers and the consulting psychiatric capacity come with the program.
Will this help my quality scores?
The behavioral health measures fail on engagement, not on clinical judgment. Reaching and retaining the patient is exactly what the program is built to do.
Is this another system to log into?
No. Flags, notes, tasks and social needs are written into the chart you already work in.