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Help Shape Findhelp’s Behavioral Health Network
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1.
Organization Name
(Required.)
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2.
Primary Contact Name
(Required.)
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3.
Role/title
(Required.)
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4.
Email address
(Required.)
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5.
Which best describes your organization?
(Required.)
Medicaid health plan
Commercial health plan
Hospital or health system
Integrated delivery network
Other (please specify)
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6.
Roughly how many behavioral health referrals does your organization handle per month?
(Required.)
<50
50–250
250-1,000
1,000+
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7.
Primary Behavioral Health use cases (select all that apply):
(Required.)
ED discharge
Inpatient psych discharge
Primary care referrals
Crisis stabilization
Substance use
Care management
Other (please specify)
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8.
Do you currently maintain a Behavioral Health provider list or directory?
(Required.)
Yes, internal
Yes, via vendor
No
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9.
Do you have at least one navigator or team that could participate in workflow testing?
(Required.)
Yes
No
Not sure
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10.
Are you able to participate in two structured feedback sessions per month during the program?
(Required.)
Yes
No
Not sure
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11.
How would you be interested in participating in this research? (Select all that apply)
(Required.)
Joining an early adopter program
Participating in a paid 1:1 research interview
Reviewing concepts and prototypes
Testing beta products
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12.
Are you open to participating in at least one of the following? (optional but encouraged)
(Required.)
Webinar
Conference session
Case study
Pull quotes/testimonial
Video
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13.
What are you hoping to improve most with this program? (select up to 3)
(Required.)
Placement speed
Access to real availability
Quality metrics
Parity compliance
Care transitions
Staff efficiency
Reporting and documentation
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14.
Briefly describe your current biggest challenge with behavioral health placement.
(Required.)
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15.
We will begin in early April, with opportunities to review designs and make recommendations on workflows. Would your users be ready to engage with the Findhelp team as early as April?
(Required.)
Yes
No
Not sure
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16.
This is a limited access program with defined scope and MVP access. Do you understand this is a collaborative program with structured feedback requirements?
(Required.)
Yes