About Us

About PsycHealth Patient Care Management

We believe that compassion and consideration is of utmost importance.

Welcome to PsycHealth

PsycHealth is an NCQA accreditied managed behavioral healthcare organization, founded by Dr. Madeleine Y. Gomez in 1989. PsycHealth’s operation is turnkey. Clients outsource the management and delivery of behavioral health services to PsycHealth for an administrative or capitated risk fee. PsycHealth employs a Psychiatric Medical Director, participates in client UM and Quality Meetings, and invites practitioners associ- ated with clients to participate on its Peer Review Committee.

PsycHealth’s case management program is proprietary. Known as Virtual Wards, it is a population health stratification tool specifically designed for behavioral health. This tool enables PsycHealth to effectively risk assess members and ensures the appropriate level of intervention. Another noteworthy program is Helping Hands. Under this program, patients are engaged at critical milestones such as the anniversary of a hospitalization to prevent recurrence. To support a more holistic approach to treatment, PsycHealth maintains a robust Release of Information Program to enhance care coordination with PCPs and other practitioners.

Utilization statistics are below moderately managed Milliman Care Guidelines. Consistently, PsycHealth scores 100% on payor utilization management and claims audits. This data and more, is part of PsycHealth’s core reporting package.

Our Mission

PsycHealth is committed to the preservation of fair and ethical services coordinated with compassion, consideration for those individuals seeking behavioral health treatment regardless of the individual’s culture/ethnicity, language spoken, gender, religion, disability, special or complex care needs, or sexual orientation.

Psychealth advocates for and upholds the rights of the child and the rights of the older adult- positioned against abuse of all types including child abuse, abuse of the elderly, emotional abuse, sexual abuse, domestic violence, and abuses of power.

Reduce the stigma of seeking and receiving mental health services and substance use disorder treatment.
As we help each person, we help our families, our friends, our communities and ourselves.

Our Vision

To establish and strengthen successful partnerships with practitioners, facilities, and businesses that align with our commitment to the wellness of individuals, their families, and the community through education, prevention, intervention, and treatment.

Client Services

  • Dedicated Crisis Line

  • Utilization Management & Discharge Planning

  • Telehealth

  • Credentialing Verification Organization

  • 24/7 on call and emergency coverage

  • Case Management

  • Network Development & Direct Contacting

  • Claims Payment

Clinical Programs

  • Transitional Care Visits

  • Behavioral Health, Substance Use and Co-Morbid Services

  • Outreach and Engagement Program

  • Community Resources and Support Liaison

  • Perinatal Depression Program

  • Home Intervention Program

  • Holistic Health and Wellness Program

  • Clinical Care Coordination/Complex Care

  • Clinical Screening Programs

24 Hour Inpatient Care

Acute Inpatient Psychiatric Admission

Inpatient psychiatric admission is required for treatment of a psychiatric disorder requiring admission to a hospital for 24 hour care to reduce the imminent risk of harm to self or others.  Assessment of the member’s presentation deems that services and care cannot be safely provided at a less restrictive setting.

Detoxification is a medical regimen intended to safely reduce the amount of alcohol or drugs from a member’s body and to control the degree of active withdrawal symptoms.  These services may be provided in an inpatient or ambulatory setting depending on the needs of the member.  Chemical detoxification is always conducted under the supervision of a qualified physician.

Inpatient substance abuse treatment will be utilized in only the most high risk/acute cases requiring 24 hour supervision and is designed to provide short term and intensive educational and multi-disciplinary treatment.

Adolescent substance abuse residential treatment will be utilized in only the most high risk/acute cases requiring 24 hour supervision and is designed to provide short term and intensive educational and multi-disciplinary treatment and a stable environment to facilitate the recovery process.

Partial Hospitalization Program/Day Treatment (PHP)

PHP is a program providing a more comprehensive and multi-disciplinary treatment plan at a less restrictive level of care than an inpatient setting to address mental health and/or substance abuse disorders.  Services are provided in an outpatient setting with a minimum of six hours a day and a frequency of at least three days a week.

Intensive Outpatient Program (IOP)

IOP Programs provide a more comprehensive and multi-disciplinary treatment plan at a less restrictive level of care than a day treatment or inpatient setting to address mental health and/or substance abuse disorders.  Services are provided in an outpatient setting with a minimum of three hours a day and frequency of at least three days a week.

Outpatient Ambulatory Treatment

Outpatient Home Health

Psychiatric home health benefits will be utilized as an acute, short term, crisis stabilization for members who are assessed to be free of imminent risk for harm to self or others and are not in need of a more structured level of care and one of the following: 1) member is homebound or 2) there is clear and reasonable evidence that member requires home health care in order to decrease risk of re-hospitalization.

Outpatient medication management benefits will be utilized as stabilization for members who are assessed to be free of imminent risk for harm to self or others and are not in need of a more structured level of care. Outpatient medication management sessions generally occur monthly and always in an office setting.

Outpatient psychotherapy benefits will be utilized as an acute, short term, crisis stabilization for members who are assessed to be free of imminent risk for harm to self or others and are not in need of a more structured level of care.  Outpatient psychotherapy sessions generally occur weekly and always in an office setting.

Psychiatric consultations will be utilized when a member is on a medical unit in a hospital for medical problems and is exhibiting symptoms consistent with imminent risk for harm to self or others, psychosis or member needs chemical dependence treatment.