Establishing Solid Partnerships and Superior Quality
Initiatives to Provide the Best Possible Outcomes for Members

CompCare offers a flexible system of comprehensive, compassionate, and cost-effective behavioral health products and services that can be specifically tailored to meet your individual needs. Additionally, the partnership of CompCare's management and clinical staff with our network of behavioral healthcare providers offers a blend of quality service delivery unparalleled by other organizations. The clinical philosophy, which directs all aspects of CompCare's services, focuses on the appropriateness of the care and services required to assist a member in achieving optimal level of functioning without compromising their quality of care or safety.

Headquartered in Tampa, Florida, CompCare currently provides behavioral healthcare services to over half a million members nationwide, across Medicaid, Commercial, Employer Group, Medicare, and Employee Assistance Program (EAP) lines of business.

Core services of our subcontracted behavioral health management:

Our primary concern is ensuring that all members are able to easily access services by calling the toll-free number. We continuously monitor call statistics to make sure that staff rapidly respond to members who need assistance. The following graph illustrates our call abandonment performance. Our goals are consistent with National Committee for Quality Assurance (NCQA) guidelines. Our average speed of answer for the Member Live Answer line during 2005 was 10.1 seconds. Our 2005 annual call abandonment rate average was 1.57%. As the chart for 2006 demonstrates, we continuously exceed the goal of a less than 5% abandonment rate.

Access to CompCare's Services
CompCare's licensed Care Managers and psychiatrists perform the following functions:

• Assist as needed, in determining the member's eligibility and benefit plan design, then authorize treatment as medically appropriate.
• Review all levels of psychiatric care according to CompCare's Level of Care Guidelines*, policies and procedures.
• Monitor and review all cases assigned at intervals as outlined by the CompCare Level of Care Guidelines to determine the appropriateness of the current treatment plan.
• Communicate important clinical information to Primary Care Physicians (PCPs) and/or coordinate psychiatric and medical care through the health plan.
• Coordinate with community-based mental healthcare and substance abuse provider systems for aftercare planning, alternative levels of treatment, and monitoring high-risk members.
  
  *CompCare's Level of Care Guidelines are available on our website at compcare.com or you may request a copy from our Quality Department by calling 813-288-4808.

CompCare's Referral Process
Members may attempt to access care from a variety of methods. Regardless of the route chosen, CompCare's intake process assures that any entry point results in an immediate assessment. If a member calls for routine care, CompCare ensures members are matched to the most appropriate behavioral healthcare provider. This is accomplished through a systematic triage process that obtains enough information to screen for specific clinical need(s) and potential risk, identify provider requested or required specialty, and refer to the appropriate provider. This referral process is made more effective by the use of an automated provider information system that allows for searches by both zip code and specialty information. Specialty information available on our behavioral healthcare providers includes language spoken, diagnostic specialties, technical specialization, and expertise with specific populations. This automated provider information system promotes an excellent match between member and behavioral healthcare provider.

CompCare's Assessment and Referral Department (A&R) services all callers who present for routine/non-urgent care by arranging an appointment with a conveniently located behavioral healthcare provider. In most cases, the member chooses to schedule their own appointment at their convenience after speaking with one or more prospective providers. However, the A&R Department is available to personally assist the member in making the appointment using three-way calling, to ensure the appointment is timely.

All members are referred to a network provider for initial outpatient sessions. To expedite treatment and facilitate early intervention, members may freely access initial services. For additional outpatient sessions, the member's behavioral healthcare provider contacts the CompCare office to complete a clinical review process.

This review process takes place between our licensed Care Managers and the participating CompCare network provider. For authorization of sessions beyond the initial ones, the provider submits a written outpatient treatment plan. A Care Manager reviews each outpatient treatment plan for compliance with clinical level of care guidelines and medical necessity criteria. Outpatient care is most frequently authorized in a standard block of sessions; however, Care Managers will work with providers in unique clinical situations, including, but not limited to:

1. Care is complicated and consultation is requested.
2. Care does not meet Level of Care Guidelines.
3. Referral is needed for additional or complementary services.
4. Treatment is approaching termination.

When a member calls and requests urgent or emergent care, a licensed Care Manager refers that member to treating providers for a prompt assessment. The Care Manager follows up to ensure that access to emergent care is immediate and that access to urgent care is within 48 hours. Primary Care Physicians (PCPs) and/or their staff, the member, EAP professionals or other concerned persons need only make one call to CompCare's emergency services and we will ensure that safety needs are met with rapid intervention.

Provider Credentialing and Network Management
CompCare has a comprehensive credentialing process that is used for its ongoing network development. We believe this review and verification process helps to assure members that they receive excellent care from highly qualified professionals. CompCare's networks include a full range of behavioral and clinical professionals and facilities across a broad range of sub-specialists, specialized services, and cultural diversity to meet specific member needs.

CompCare fosters a supportive environment for its network of behavioral health care providers. This support is provided through education; partnering; and ongoing review, analysis, and action plans that have improved the safety of provider practices and promoted excellence in clinical care and quality of service to members.

Network Development
CompCare has an extensive network of over 8,000 credentialed providers throughout the country. This network of providers includes facilities, psychiatrists, psychologists, nurse practitioners, and Master's level therapists who specialize in the diagnosis and treatment of mental health and substance abuse.

Our network is continuously expanding based on client and member needs. Contracts are executed rapidly and the contracting process can be expedited when necessary through the use of a Letter of Agreement (LOA) within one business day. CompCare also has a One Time Agreement (OTA) process that can be used to assure the care of a member at a certain facility for one episode of care.

Credentialing Review and Verification Process
At the time of initial application, potential providers are required to submit evidence to support current and accurate information to become credentialed providers. The Provider Selection Committee initially reviews provider applications. At this committee, CompCare will review résumés and site visits that have been conducted at the applicant's service location(s). Upon review, applications are forwarded to our NCQA certified Credentialing Verification Organization (CVO) for further verification. Applications are then returned to CompCare's Credentialing Committee for approval of those professionals that meet our standards. CompCare follows NCQA guidelines for credentialing and recredentialing providers.

Provider Profiling
CompCare continuously monitors network provider performance. Provider Profiling is used to review practice patterns, youth and family satisfaction, unusual incidents, etc. This is done through data analysis, random record reviews, time-specific Quality Management studies, Care Management comments/complaints about providers, and claims issues. If at any time, a member has a concern or is not satisfied with a provider's performance, CompCare addresses the issue with the provider or facility and requires a response from the provider. The Credentialing Committee can refer providers to the Peer Review Committee, which is comprised of network providers who address quality of care issues and make recommendations for action.

Recredentialing
In accordance with NCQA standards, re-credentialing of network providers/practitioners is completed every three years. Through the re-credentialing process, CompCare performs a more comprehensive analysis of a provider/practitioner's quality practices. In essence, the process becomes a focal point of all ongoing quality related activities. Determination for recredentialing process occurs six months prior to the expiration of network privileges. At that time, CompCare submits a letter to the provider/practitioner requesting updated licensure, liability insurance, an updated completed application, and professional credentials to be examined by the CVO for reappointment.

Member and Customer Service
CompCare's Customer Service Department monitors the satisfaction of members and providers through annual surveys, a customer service database, appeals and denials, and other tools described in our Customer Service Program.

Automated Customer Tracking System
Any staff member receiving a call, in which the member, Provider, or other relevant stakeholder makes an inquiry or expresses dissatisfaction will initiate the customer service process, to include completing an internal complaint form and forwarding the form to the Quality Assurance Specialist.

The process for an inquiry includes receipt, investigation, and response. The process for a complaint includes receipt, resolution, and explanation of appeal rights. If resolution is not completed during the call, the QA specialist will follow-up to ensure completion within the required timeframe. Completion of a complaint may include forwarding to the appropriate department director to review the issue and involve their staff, sending internal reminders regarding resolution deadlines, and/or entering into the Automated Complaint Tracking System (ACTS), to generate appropriate letters and explanation of the appeal rights.

ACTS allows comprehensive tracking and trending of complaints to ensure quality improvement activities occur throughout the year. An annual complaint analysis generated from ACTS assists in assessing Quality of Care, Access, Attitude and Service, and Billing/Financial Issues.

Written complaints from members are forwarded to the health plan to address unless delegated to CompCare by a health plan.

Member and Provider Satisfaction
CompCare strives for high levels of both satisfaction from our members, providers, and clients. The annual Member Satisfaction Survey reviews members' satisfaction with Providers and CompCare processes, services, accessibility, availability, and acceptability specific to cultural, ethnic, communicative and linguistic needs to identify those areas in need of improvement. The survey also asks questions regarding the utilization management process. The survey uses a statistically significant number of members and asks questions of adult members and parents/caretakers of children and adolescent members. Both English and Spanish surveys are available to meet the cultural needs of our membership.

In addition, the Member Satisfaction Team provides a vehicle to ensure the accountability and responsiveness of CompCare to the needs and concerns of members and families. Staffed by members, including those with serious mental illness as well as individuals in recovery, the Member Satisfaction Team administers the survey tool to assess member's satisfaction with the effectiveness of care and services received. The team provides its findings to the Quality Council, and staff members convey the concerns, suggestions and successes of members and their families to the Council. Member Satisfaction Team feedback is helpful in identifying member-specific and system-wide problems, as well as in developing new solutions and program innovations. The information gained from these efforts is important in better adapting the system to the needs of members and their families and improving the usefulness of member-focused information, such as the Member Information Handbook.

A key component of quality outcomes for our members is exceptional partnerships with our providers. CompCare's Customer Service and Provider Service staff work hard to maintain a high level of provider satisfaction. To measure provider/practitioner satisfaction, we annually request feedback on many aspects of our services and use this knowledge to better our service delivery systems.

Quality Management
Continuous quality improvement is essential to optimize the delivery of care and services. Total quality management is an integral part of CompCare's management philosophy. Through its Quality Management (QM) Program, CompCare strives to maintain the highest levels of clinical care and member services.

Monitoring Performance
The QM Program continuously monitors clinical care and quality of services. Key performance indicators such as, access to services, the appropriateness, efficiency, coordination, and outcome of care, potential risk to the member, provider performance, care management, and other important factors are benchmarked and goals are established. These benchmarks and goals are set to identify specific opportunities for improvement, when a performance problem is in its earliest stages.

The continuous monitoring process consists of the following:

1. Data collection and analysis.
2. Design and implementation of action plans to improve processes or outcomes.
3. Evaluation of the effectiveness of action plans.
4. Interventions through follow-up monitoring and periodic measurements.

The components to the process are the following:

1. Provider appeals and satisfaction.
2. Member, family, other care-involved adult, provider, and other stakeholder feedback (grievance and satisfaction).
3. Identification of high-volume, high-risk, or high-cost services, conditions, and diagnoses (utilization management).
4. Use of epidemiological data relevant to the population served.
5. Use of benchmarked indicator data to identify potential areas of system performance concerns.
6. Contractual, regulatory, or accreditation requirements.
7. Evaluation of work process flows of functions and activities affecting delivery of care and service.
8. Clinical record review findings.
9. Authorization and administrative data.
10. Encounter data.
11. Customer complaints and grievances.
12. Satisfaction surveys of members, family/guardian/responsible adult, and providers.
13. Medical record reviews.
14. Provider performance data.

Sample performance goals for some of the quality management indicators routinely evaluated by CompCare include:

1. Call abandonment rate will be less than 5%.
2. Access to emergent care; life threatening immediate, not to exceed 2 hours.
3. Access to emergent care; non-life threatening within 6 hours
4. Access to urgent care within 48 hours.
5. Access to routine care within 10 days.

CompCare responds to these opportunities for improvement with prompt resolve, working to correct any potential difficulty and to prevent or minimize recurrences.

Prevention Programs and Medical Integration Innovative programs driven by our QM department have enhanced our partnerships with our clients. To date, we have developed Prevention and Early Intervention Programs for co-morbid disease states and for pharmacy, quality, and cost management that include:

1. Diabetes and Depression.
2. Congestive Heart Failure and Depression.
3. ADHD Management by PCPs.
4. Psychotropic Medication Management (ASO).

Goals and program initiatives can be customized based on analysis of the encounter information and goals of the overall Quality Management Plan.

Information Technology
Information Technology (IT) includes member eligibility, telephone and computer hardware and software updating, loading and maintenance, computer firewall and virus protection, data integrity and health information confidentiality. The current information system, PowerSTEPP, supports day-to-day care management functions for all operating departments including the Call Center, Customer Service, Claims, Provider Services, and general administrative reporting. Further enhancement of the computer's capabilities continue and will include real time management reports, automated authorizations, electronic claims adjudication, and Provider look up of claims status, member eligibility and explanation of benefits.

Quality and Utilization Management
The CompCare systems provide the processing hub for all operating areas. Information is collected and maintained in a single database with all relevant data relationship automatically maintained by the system. All activities of a member and their provider are recorded and tracked over time. The primary system provides nightly updates to a separate data warehouse system that uses the information to generate all reports for all operating units within CompCare. All the information reported is reviewed by the UM department and Senior Management to monitor the accuracy and integrity of information used within CompCare and distributed to our clients.

Claims Processing
All claims, whether originating from paper or delivered electronically, pass through the same entry point into the CompCare systems. Front end edits and data validation are applied to each and every claim entered into the system and payment or denial of a claim is determined by validation of member information, provider information and benefit coverage for the services rendered. The results of adjudication are reviewed before payment is made or a denial letter is sent. Printing of checks and production of an EOB/EOP is outsourced to a third party printing vendor. Ancillary processes handled by the system include claims adjustment, claim reversal, voids, EOB reprints and audit reports.

Privacy and Security
CompCare has a comprehensive security policy in place that addresses physical access, user accounts, workstation and server security policies, and all network-related activity. Physical access is controlled at the main network operations center in Tampa through locked security doors. Access to the network operations center is given only to key IT support personnel. Separate user accounts are given for network access and application access. These accounts abide by internal policy that dictates periodic changes, uniqueness of passwords, and lockouts when unsuccessful login attempts are made. User interface terminals at all network and application servers are locked automatically when not in use. All access to the network is funneled through the Windows NT security model, including remote dial-up access. All Internet traffic routes through the CheckPoint firewall server. The monitoring and notification of attempted unauthorized access and other security-related events are achieved by internal applications and Internet Service Provider monitoring.

Internal management controls of data meet industry standards and are implemented as a component of the corporate Business Continuity Plan. This plan accounts for daily as well as disaster recovery controls. Warehousing of data is maintained through a contract with a bonded data storage company specializing in business recovery operations. The data is secured in a data vault facility with access limited to named officers of CompCare.

Finally, CompCare is fully compliant with all Health Insurance Portability and Accountability Act (HIPAA) guidelines and requirements for ensuring the confidentiality of automated client information.

Reporting
CompCare's IT system produces a wide variety of online, pre-programmed and customized reports. These reports are used in different ways by management to monitor operations, membership, providers, claims, service utilization, and financials. Each report takes raw data and processes it into a meaningful tool used to evaluate performance. This capability enables effective evaluation of behavioral healthcare services and related information at a glance, enhancing the decision-making process.

Reports
CompCare produces management reports in six general areas:

1. Operations
2. Membership
3. Provider
4. Claims
5. Utilization
6. Quality Management

Reports from each of these areas are designed to meet specific county, state, federal, and organizational needs. In addition, the flexibility of the system allows CompCare the ability to produce reports at any time during the month, according to contract specifications. Reports are produced routinely on a monthly or quarterly basis, but can also be produced for any specified time intervals desired by our clients.

Eligibility
Currently, CompCare receives monthly eligibility files from our vendors. If necessary we can receive them more frequently. Most files are processed within 13 business days. Our system has edits in place that identify problems with the layout of the file or issues with critical data elements that are necessary for proper system performance as it relates to the patient. Any problems with the file are reported during the initial setup of file loading. Some issues can be manually fixed and then the file can continue to be processed.

All member history is kept in the system indefinitely. Claims are processed based on the date of service. Member group and benefit information is attached to the claim based on the member's benefit effective at the time the service was rendered. Any member that is not loaded into the system is reported on an error report. If necessary this report is shared with the client so that they can assist with correcting the problems. Once the errors are corrected, CompCare loads the excluded members into the system either via a new file received from the client or a file created by CompCare.

Claims Processing
The CompCare system provides customers with a powerful yet flexible platform to meet their individual program requirements, helping to reduce operating costs, claim inventory, and processing time. CompCare's system provides claims processing, adjustment, development, and control for claims according to contract requirements.

CompCare operates an integrated claims processing system designed to meet the requirements of Commercial, Medicare and Medicaid claims format standards including, but not limited to, HCFA-1500 for non-institutional providers, UB-92 for institutional providers, Universal Form C for pharmacy, as well as other nationally acceptable forms. This enables us to accurately and efficiently process claims for payment or denial according to applicable Federal and State laws, regulations, and other requirements. CompCare's claims adjudication system can handle all coordination-of-benefits issues, including ERISA, Medicare, CHAMPUS, COBRA, and Commercial Plan standards. CompCare providers are continuously educated on the process required to submit clean claims. CompCare maintains claims records, audit trails, and procedures in its corporate office located in Tampa, Florida.

CompCare consistently maintains payment processing timeliness. 99.7% of claims were processed within our client's contractual timeframes during 2005. As the graph for 2006 illustrates, we consistently process claims in a timely fashion.

Anti-Fraud Measures
CompCare also incorporates proactive anti-fraud measures that protect our clients through provider training and education programs, audits, and other measures that significantly reduce the number of suspect claims adjudicated for payment. Regularly scheduled, random audits, as well as focused investigative efforts, ensure legitimate claims are paid in a timely manner, with suspect claims reviewed for potential fraud and abuse to minimize unnecessary risk.

Value Added Services - The BRIDGE^TM

Behavioral Pharmacy Management
Introduction
Behavioral Pharmacy Management (BPM) analyzes pharmacy claims data to identify outlier prescribers and members. We offer an Opportunity Analysis that reviews two years of pharmaceutical data to identify behavioral, pain and sleep medications patterns of use. We make comparisons which are developed from industry standards and expert panels that are updated to reflect new medications and changes in use. Outlier members are identified and tiered by risk level for intervention through our Integrated Health Care Management Program.

The Model
BPM uses 28 Quality Indicators to track physician prescribing practices, comparing those practices to evidence-based and nationally recognized best practice prescribing standards. A small number of outlier physicians in each network account for a high percentage of possible deviations from best practice standards. These outlier physicians, flagged by the BPM Quality Indicators, receive 'advice' letters informing them of member, medication variance, literature references, and information comparing their prescribing practices to those of their peers (benchmarking). If the same prescriber receives two 'advice' letters for the same outlier event, a peer-to-peer consultation is offered. Documentation of the activity is provided for health plan use in its consideration of the physician's network status and risk to the member.

CompCare's Awareness Plan provides educational information to outlier prescribers of behavioral health medications, in order to increase their awareness of inappropriate or ineffective use of behavioral, pain, and sleep medications; redundant prescriptions; lack of coordination among prescribers; and discontinuation of treatment for members. Educational materials include individualized, detailed and summarized member reports, prescriber comparison reports, and references to nationally accepted practices. Outreach to outlier prescribers is provided through peer-to-peer contacts to discuss clinical cases or overall practices specified in the prescribers' educational materials. Contacts are made by Psychiatrists with experience and/or board certification/eligibility in psychiatric specialties; i.e., child, adolescent, geriatric, and chemical dependency medicine. This allows prescribers the opportunity to ask questions, clarify misinformation, and discuss clinical practice in a mutually respectful manner.

While some behavioral pharmacy standards are based on the hard evidence of clinical research, multiple new psychotropic drugs have recently been approved by the Food and Drug Administration (FDA). These new drugs have not yet had adequate time for longitudinal evaluation. To fill the gap and guide the use of these medications in real-world situations, the following standards and guidelines are used: The Texas Medication Algorithm Program (TMAP) and the American Psychiatric Association (APA). The voluntary process is designed to influence the prescriber's selection of appropriate medication and dosing range.

CompCare's Behavioral Pharmacy Management Provides:

1. Opportunity Analysis for two years of claims paid data to identify the outlier patterns and projected savings.
2. Monthly generation of letters to prescribers based on health plan pharmacy claims paid file submission, as modified by health plan.
3. Data reports based on Quality Indicators as modified to meet health plan requests in an acceptable electronic or paper format.
4. Tailored implementation of the 'advice' letters based on health plan practice.
5. Peer to peer consultation, as appropriate.
6. Savings of not less than 30% of the trend of increased cost of behavioral, pain, and sleep medications.
7. Savings on costs for behavioral and medical services to be forecast with the Opportunity Analysis.
8. Identification of outlier members for tiered intervention through Integrated Health Care Management services.

Integrated Health Care Management
CompCare's disease state management program model, Integrated Health Care Management, delivers behavioral and medical health care as a single coordinated and comprehensive service for the at-risk member. As one integrated service, CompCare ensures the at-risk member receives the most efficient, effective, and safe treatment consistent with best clinical practice and meeting nationally recognized standards of care.

CompCare's model uses care management provided by our highly skilled and experienced licensed clinicians to strategize interventions in member centered plans of care.

Care management decision-making is based on:

• CompCare's Level of Care Guidelines (LOCG) developed to determine an member's appropriate level of care based on medical necessity and clinical needs.
• CompCare's Preferred Practice Guidelines developed to establish mixed service protocols.
• Nationally recognized Clinical Practice Guidelines from the American Psychiatric Association (APA) for Major Depression, Schizophrenia, and Substance Use and the American Academy of Child and Adolescent Psychiatry (AACAP) for Attention-Deficit Hyperactivity Disorder (ADHD) to determine best practice for specific diagnoses.

Planned Interventions and Care Management Tiers
CompCare's model consists of four action plans utilizing four approaches for at-risk members identified from health plan pharmacy usage and CompCare utilization data. The first three action plans, Awareness, Prevention, and Behavioral Support affects all at-risk members while the fourth action plan, Behavioral Care Management, affects the most at-risk members. Within Care Management are four tiers based on severity of risks associated with Cost, Utilization, Compliance, and Quality.

Awareness Plan
The Awareness Plan provides educational information to outlier members to increase their awareness of potential health problems related to poly-pharmacy, inappropriate use or non-compliance with medication regimes, and issues of co-occurring behavioral and medical disorders.

Prevention Plan
CompCare's Prevention Plan works to provide primary, secondary, and tertiary prevention for outlier members.

The focus of primary prevention is to remove or lessen the risk factors and to enhance members' self-care.

• The focus of secondary prevention is to identify problems early and to receive prompt treatment for an illness or disorder to reduce its frequency or duration.
• The focus of tertiary prevention is to reduce impairment or disability following the development of an illness or disorder.

CompCare offers outreach to at-risk members through telephonic and written contacts to discuss at-risk issues specified in the members' educational materials. These contacts are made by well-trained and experienced CompCare staff to allow members the opportunity to ask questions, clarify misinformation, and discuss their needs for the right treatment, at the right time, and at the right level of care. CompCare tracks, trends, and reports on contacts to members.

Behavioral Support Plan
CompCare's Behavioral Support Plan provides treatment coordination with outlier members and relevant stakeholders, with appropriate release, who are involved in their care to ensure both behavioral and medical needs are met.

CompCare coordinates the member's treatment by calling the member, relevant stakeholders, including the PCP, health plan, and/or behavioral prescribers and/or therapists, to communicate treatment needs identified by the member, stakeholders, or CompCare, to set up consults, and assist in resolving any barriers; i.e., lack of benefits, transportation, etc. Communication ensures care is safe, appropriate to need, timely, unduplicated, and costs are well managed. Calls made to the member and stakeholders are entered into a database, known as IMPACT, that allows CompCare to track, trend, and report coordination of care.

Behavioral Care Management Plan
CompCare's multi-tiered Behavioral Care Management Plan is the clinically-driven care management of individual members identified by CompCare and the health plan to be most at-risk. CompCare uses the clinical expertise and experience of licensed behavioral health clinicians to quickly intervene at increasing levels of intensity to achieve the "best" outcomes for the members regarding cost, utilization, compliance, and quality and promote self-care, safety, and maximum bio-psycho-social functioning.

• Tier 1 - Low Risk Care Management
  Outlier members with Low Behavioral-Low Medical cost and utilization are categorized into Low Risk Care Management. CompCare uses select network providers to meet these members' needs for coordinated services of behavioral medications and therapy and communicating with the PCP or relevant stakeholders.
• Tier 2 - Medium Risk Care Management
  Outlier members with Low Medical-High Behavioral cost and utilization are categorized into Medium Risk Care Management. CompCare uses select network providers to meet these member's needs for coordinated services of those under Low Risk and additional attention to discharge planning and after care from inpatient hospitalizations, living arrangements, transportation, and medications. This plan will arrange for an appointment within seven (7) days after discharge with a behavioral and/or medical professional to assess their health status.
• Tier 3 - High Risk Care Management
  Outlier members with High Medical-Low Behavioral cost and utilization are categorized into High Risk Care Management. CompCare Care Managers provide telephonic contacts to the members and PCPs/health plans to meet these members' needs for coordinated services of those under Low and Medium Risk and additional attention to co-occurring behavioral and medical issues.
• Tier 4 - Extreme Risk Care Management
  Outlier members with High Medical-High Behavioral cost and utilization are categorized into Extreme Risk Care Management. CompCare Care Managers provide telephonic and on-site contacts to the members and PCPs/health plans to meet these members' needs for coordinated services of those under Low, Medium, and High Risk additional attention to co-occurring behavioral and medical issues.

CompCare's Integrated Health Care Management Provides:

1. Stratification of outlier members into tiers for intervention, identified from health plan monthly submission of pharmacy and medical paid claims data.
2. Tiered intervention of members appropriate to their needs.
3. Coordination of care with involved primary care practitioners, prescribers, and behavioral health providers.
4. Electronic or paper data reports, as needed, documenting the Integrated Health Care Management services by member.
5. Coordination of care with community behavioral health providers on a fee basis. This will include enhancing access, obtaining release of information, treatment plan and documentation of services provided monthly.
6. Coordination with health plan's case management staff for medical, co-morbid conditions.

Conclusion
In summary, CompCare's well-established systems of care and service brings our clients and their members comprehensive, compassionate, and cost-effective behavioral healthcare and substance abuse services. For all of our members, we administer a consistent and effective product with continuous monitoring, improvement, and technological advancements to ensure quality of care and service.

Why Choose CompCare?
Our outstanding customer focus means that you'll always receive personalized attention to ensure your unique needs are met.

Our exceptional Quality Management exemplified in our Full NCQA Accreditation means that you'll receive high quality and efficiency in everything we do.

Our versatility means that we will develop a unique program that's right for you.

Our focus on innovation means we're always coming up with ways to improve our programs and find solutions for the issues in our changing healthcare environment, resulting in increased efficiency and cost-effectiveness for our clients.

Our mission statement illustrates our commitment to providing the best possible service for our clients: