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The Psychiatrist's Guide to Managed Care Contracting

The Psychiatrist's Guide to Managed Care Contracting
Author:
Publisher: American Psychiatric Publishing
Total Pages: 92
Release: 1997
Genre: Medical
ISBN:

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Because of growing enrollment in managed care plans, psychiatrists are finding it necessary to sign contracts with managed mental health care programs in order to receive third-party payment. These contracts often lead to complications and form a key area of concern for clinicians. The Psychiatrist's Guide to Managed Care Contracting helps psychiatrists make sense of the legal issues arising from their managed care contracts. In a step-by-step manner, this useful guide develops the framework for the crucial decisions that must be made and highlights the strategies a psychiatric practice can employ to shape the contract in its favor. It reviews standard contract provisions and the issues involved so that potential problems can be identified early in the negotiating process. The Psychiatrist's Guide to Managed Care Contracting also details the essential groundwork and preparation that should be completed before a psychiatric practice enters negotiations, including practice assessment, financial planning, marketing, and the development of administrative support. Equipped with this knowledge and advice, psychiatrists can negotiate from a position of strength and develop a favorable contract that ensures the survival and prosperity of their practice.


The Psychiatrist's Managed Care Primer

The Psychiatrist's Managed Care Primer
Author: American Psychiatric Association. Office of Economic Affairs and Practice Management
Publisher: American Psychiatric Pub
Total Pages: 112
Release: 1997
Genre: Medical
ISBN: 9780890424506

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Because an increasing number of patients are covered through managed care plans, psychiatrists need to understand the managed care system in order to answer their patients' questions and ensure the continued prosperity of their practices. To assist clinicians in these challenging times, The Psychiatrist's Managed Care Primer arms psychiatrists with the information and tools they need to flourish within the managed care environment while simultaneously delivering quality patient care. This monograph provides an overview of the evolution of this industry; detailed explanations of current managed care models, operations, and anticipated trends; and practical advice on key problem areas. It focuses on the pressing issues of utilization management and capitation as well as important regulatory, ethical, and legal issues psychiatrists confront under this system. The potential impact that managed care systems have on their patient referrals, clinical decision-making autonomy, and income is also examined closely. Equipped with the sophisticated understanding of managed care supplied by this primer, psychiatrists can make the important decisions that will ensure the survival of their practice.


The Psychiatrist's Guide to Practice Management

The Psychiatrist's Guide to Practice Management
Author:
Publisher: American Psychiatric Publishing
Total Pages: 0
Release: 1997
Genre: Psychiatry
ISBN: 9780890424513

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As managed care companies gain increasing control over the mental health care market, many psychiatrists not under contract with a managed care plan have been excluded from significant numbers of potential patients. As a result, psychiatrists must pay more attention than ever before to practice management and other business-related issues. The Psychiatrist's Guide to Practice Management provides psychiatrists with important advice on how to make their practice capable of entering agreements with managed care organizations. This important guide identifies key areas (including financial, regulatory, promotional, administrative, and geographic issues) that must be considered in order to adapt the practice to make it more appealing to managed care companies. An additional chapter covers physician networks and alliances that compete directly against managed care organizations. It also provides crucial advice for psychiatrists who wish to develop a private practice based on traditional fee-for-service and private pay plans. By using this handy guide, psychiatrists can build a thriving practice inside or outside the managed mental health care system.


The Psychiatrist's Guide to Capitation and Risk-based Contracting

The Psychiatrist's Guide to Capitation and Risk-based Contracting
Author: American Psychiatric Association. Office of Economic Affairs and Practice Management
Publisher: American Psychiatric Publishing
Total Pages: 0
Release: 1997
Genre: Capitation fees (Medical care).
ISBN: 9780890424537

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In today's competitive economic environment, many psychiatrists are entering capitation agreements with managed care organizations. In exchange for a flat fee for each member of a benefit plan, the psychiatrist must provide all services needed by group members regardless of the amount of service required or its cost. The Psychiatrist's Guide to Capitation and Risk-Based Contracting provides the tools that will allow clinicians to navigate this complex process and develop a successful capitated program. It includes an overview of the primary financial, administrative, and clinical issues involved in such a contract. This guide contains helpful advice on how to calculate an equitable capitation rate, evaluate and negotiate a contract, minimize the financial risks involved, and resolve numerous other issues crucial to a successful capitation contract. An interactice mental health capitation demonstration disk especially designed and developed to educate psychiatrists about the interrelationships between mental health utilization, mental health service cost, and managed care capitation rates accompanies this book. By using this guide, clinicians will be able to manage this competitive environment in the best interests of their patients and their practice.


Utilization Management

Utilization Management
Author: American Psychiatric Association. Committee on Managed Care
Publisher: American Psychiatric Pub
Total Pages: 84
Release: 1992-01-01
Genre: Medical
ISBN: 9780890422359

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This handbook provides clinicians with timely and useful information that will help psychiatrists obtain optimal coverage of services for patients. Among the issues addressed are frequently encountered problems, confidentiality, contracting, and the process of utilization management.


The Clinician's Guide to Managed Behavioral Care

The Clinician's Guide to Managed Behavioral Care
Author: William Winston
Publisher: Routledge
Total Pages: 356
Release: 2014-02-04
Genre: Business & Economics
ISBN: 1317786289

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Managed care is a revolution impacting the practice of clinicians throughout America. The Clinician’s Guide to Managed Behavioral Care, called “a survival kit” and “must reading,” helps clinicians develop and market professional services attuned to the needs of managed care systems, manage the utilization process, and reshape an office practice or hospital-based program to become more “managed care friendly.” It is newly referenced and updated for clinicians to continue to advocate for their patients and clients. The Clinician’s Guide to Managed Behavioral Care addresses how clinicians can develop and market professional services attuned to the needs of managed care systems, how to best manage the utilization review process, how to re-shape an office practice or hospital-based program to become more “managed care friendly,” and how to best advocate for patients and clients. Readers will understand the history and evolution of attempts to manage mental health care costs and services as well as the emerging clinical, economic, and social trends that will continue to fuel changes in the mental health field in coming years. Importantly, this guide sensitizes readers to the perspectives about mental health care benefits and the treatment field held by the payor community--insurance carriers, HMO’s, and self-insured employers. It allows readers to consider a payor’s view of how professionals can play a crucial role in providing quality services while helping control spiraling mental health care costs--costs that have escalated much faster than other segments of health care. Who can benefit from this book? Practicing psychologists, social workers, psychiatrists, substance abuse counselors, marriage and family therapists, Employee Assistance Professionals, psychiatric nurses, professional counselors, program managers, hospital administrators, and health care marketing professionals will find The Clinician’s Guide to Managed Behavioral Care and invaluable resource. It is often said that in the future, all in the treatment community will be involved in “managing care” and that the most successful clinicians and practices will be those most adept at working with managed care systems on behalf of their patients and clients. This book helps you understand how! Important topics in The Clinician’s Guide to Managed Behavioral Care: the changing marketplace for mental health/substance abuse treatment services assessing market opportunities in light of managed care influences clinical service needs of managed care systems clinical innovations: examples, case studies, vignettes strategies for managing utilization review marketing strategies for office-based practitioners hospital-managed care partnerships contemporary office management strategies to control costs consumers and managed care directory of America’s HMOs directory of America’s Managed Mental Health Care Companies glossary of key terms


The Managed Care Answer Book for Mental Health Professionals

The Managed Care Answer Book for Mental Health Professionals
Author: Gayle McCracken Tuttle
Publisher: Psychology Press
Total Pages: 164
Release: 1997
Genre: Managed care plans (Medical care)
ISBN: 9780876308486

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First Published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.


Managed Care Contracting

Managed Care Contracting
Author: Wendy Knight
Publisher:
Total Pages: 392
Release: 1997
Genre: Managed care plans (Medical care)
ISBN:

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This book provides physician executives and medical group managers with a 'next generation' reference on the managed care contracting process. This handbook will educate health care providers about managed care contracting: how the contracting process works, what a standard practice contract looks like and why certain provisions are included, what questions to ask and how to evaluate a capitation rate. Provides pertinent information from professionals in the field.