Partnership Helps Tele-Behavioral Health Provider Revamp Referral Process, Integrated Approach

A new partnership aims to improve behavioral health access and care coordination in one of the most underserved, highest need parts in the country.

Frontier Psychiatry, a telepsychiatry provider, and CrossTx, a referral management solutions provider, have teamed up to make it happen. The goal is to make psychiatric care accessible to all the residents of Montana by 2025.

Founded in 2019, Bozeman, Montana-based Frontier Psychiatry is an all-virtual Montana-focused psychiatric practice that collaborates with health care providers across the state to help improve residents’ access to mental health care, especially in rural areas.


While lofty, its goal of expanding care is important: Montana’s suicide rate is nearly double the national average. For decades, the state has had one of the top five highest suicide rates in the nation.

A big reason for that is Montanans’ lack of access to mental health providers, according to Eric Arzubi, a psychiatrist and founding partner of Frontier Psychiatry. As a result, primary care clinics and hospitals — rather than specialty provider facilities — are often left to deal with patients’ mental health issues.

“Primary care is, in the best of situations, set up to care for patients who are struggling with mild to moderate psychiatric problems,” Arzubi told Behavioral Health Business. “The problem is in a place like Montana … where it’s very isolated, [primary care providers] are forced to care for patients with moderate to severe psychiatric disorders.”


Frontier Psychiatry works with those health care providers to help. It accepts behavioral health referrals from a network of providers across the state. Organizations in that network include large hospitals, federally qualified health centers, small clinics and everything in between. Arzubi and his team members then use telehealth to treat those patients.

Frontier Psychiatry’s new partnership with CrossTx, which is also based in Bozeman, improves upon that process, getting patients quicker access to psychiatric care and improving care coordination with organizations in its network.

“Typically when we would get referrals for patients, it happened in all kinds of weird ways,” Arzubi said. “It could be snail mail, fax or email. Given the technology that exists, it’s terrible what health care is still doing to try to communicate around patients.”

That lack of referral consistency was making Arzubi’s job harder and less efficient. Plus, it meant slower access to care for patients.

So, Arzubi took to LinkedIn looking for a better way to do things. He posed a question on his page: Does anyone know of a solution that can help streamline the care coordination and patient referral process?

From there, one of his connections told him about CrossTx, which allows providers to communicate about patients electronically and in real time. Those on the platform can securely send messages and documents back and forth.

“CrossTx is a lot like a social platform in structure,” Chad Nybo, CEO of CrossTx, told BHB. “We allow folks to come on our platform as providers with their organization and staff, then link to the professionals that are in their network.”

While some might compare CrossTx to a health information exchange (HEI), Arzubi says the platform goes further than that.

“HIEs tend to static and store data, where CrossTx allows us to use this data, … and actually act in service of the patient,” he said.

For Frontier Psychiatry, adding its network to the platform has meant getting patient referrals right away, rather than days or weeks after the fact. That immediacy can be life saving.

Take someone having a mental health event in the emergency department (ED), for example. Providers in the ED can use CrossTx to contact a Frontier Psychiatry specialist to get help immediately, rather than set the patient up with an appointment days later.

So far, Frontier Psychiatry hasn’t had any trouble getting the providers in its network on board.

“The way I’m talking about this is, ‘If you want us to provide [our] solution, you need to use CrossTx,” Arzubi said. “This is a must have because I don’t want to chase faxes. I don’t want to chase emails.”

Because most providers in Frontier Psychiatry’s network are in desperate need of additional psychiatric support for their patients, they’ve complied. And while it costs a fee to get on CrossTx’s platform, it also comes with potential financial benefits.

“[Arzubi’s] time is worth a lot of money to these small critical access hospitals because [behavioral health integration] makes their patients who are on Medicare eligible for extra levels of billing,” Nybo said. “So being able to document not only the coordination time spent, but the fact that they’ve reached out to a qualified behavioral health specialist unlocks a lot of revenue for them.”

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