Delivering Better Care: Practical Approaches for Behavioral Health & SUD in Rural EDs

EDs in rural communities are seeing a growing number of patients presenting with behavioral health and substance use disorders (SUD). These patients often experience long boarding times, limited access to psychiatric services, and fragmented care. This session explores practical, evidence-based strategies to address these challenges and improve outcomes for this vulnerable population.

Led by a team of clinical and operational experts, this session will highlight best practices for early intervention, ED process redesign, community resource coordination, and culturally responsive care. Real-world case examples and a preview of an upcoming ED improvement program will provide attendees with tools to drive meaningful changes at their own facilities.

At the end of this session, attendees will be able to:

  • Recognize Key Challenges – Understand the systemic barriers that contribute to poor outcomes for behavioral health and SUD patients in rural emergency settings.
  • Implement Best Practices – Apply evidence-based care models including early medication administration, standardized triage, and active treatment strategies.
  • Redesign ED Processes – Explore frameworks to optimize ED workflows and improve collaboration across clinical teams.
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Q&A

How do people stay on top of all the payer newsletters to sort through everything to pull out applicable information for the facility/provider? Who typically is going through the newsletter to gather the information to share with other staff?

Our billing specialists are organized by payer, allowing them to develop deep expertise in their respective areas. Each specialist subscribes to their payer’s newsletters to stay informed about updates and changes. Additionally, our team leads, Supervisor, and Director of Patient Accounts—along with the Prior Authorization Team—collaborate to share key insights and ensure the entire team stays up to date. This collective approach enhances our ability to navigate payer policies efficiently and provide the best possible service. 

What leadership structure do you have in place for your revenue cycle and who or what do you use for training when billers or coders need it? Especially for new service lines or common denials?

Our billing specialists are supported by a structured leadership team, including two team leads, one Supervisor, and one Director. Training for billing specialists is conducted by our Supervisor and team leads to ensure consistency and expertise. Additionally, billing specialists meet weekly with leadership to review denials and identify payer-specific trends. For new coders, who are required to be certified, training is led by our Coding Lead to maintain high standards of accuracy and compliance.

Are the billers assigned based on an alphabetical split or by insurance type, such as Medicare and Medicaid specialists?

Billers are first assigned by insurance type and then further divided by alphabetical split. Since each insurance type has multiple billers, the alpha split helps distribute the workload efficiently.

Since we have union employees, how could we implement a similar incentive to Kindal’s while ensuring compliance with union regulations?

This would depend on the specifics of your union contract. Stroudwater can work with you to review the contract and develop a compliant incentive model.

Does your Coding/HIM department manage CPT coding, modifiers, and ICD-10, or do they focus solely on ICD-10?

Our Coding team handles all aspects of coding, including CPT, modifiers, and ICD-10. They thoroughly review all provider documentation to ensure accuracy and compliance.