Negotiating managed care : a manual for clinicians / Michael A. Fauman.

Format:

Book

Author/Creator:

Fauman, Michael A., 1942-

Language:

English

Subjects (All):

Managed care plans (Medical care)--Handbooks, manuals, etc.

Negotiation in business--Handbooks, manuals, etc.

Managed Care Programs--organization & administration.

Negotiating--methods.

Practice Management, Medical--organization & administration.

Negotiation in business.

Managed care plans (Medical care).

Medical Subjects:

Managed Care Programs--organization & administration.

Negotiating--methods.

Practice Management, Medical--organization & administration.

Genre:

Handbooks and manuals.

Physical Description:

120 pages ; 23 cm

Edition:

First edition.

Place of Publication:

Washington, DC : American Psychiatric Pub., [2002]

Summary:

For many psychiatrists and other mental health professionals, the clinical review is the most burdensome and disagreeable part of managed care. In that review clinicians are asked by a representative of the managed care company to justify their patient's need for care and to defend the treatment they are providing. Clinicians usually feel at a disadvantage in these discussions because they are never quite sure what information will convince the reviewer to approve the patient's care. This does not have to be the case.

The goal of this book is to teach psychiatrists, mental health professionals, and administrators how reviewers think and how to present a case in a manner that greatly increases the likelihood that a reviewer will approve the request for care. Beginning with four questions that must be answered in every managed care review.

These and many other important issues are highlighted in brief vignettes illustrating a clinician's presentation of a patient's case and a typical reviewer's comments. This tremendously useful volume will be welcomed by every mental health care practitioner who must negotiate the current managed care landscape.

Contents:

2 Clinical Monitoring, Standards, and Liability 7

3 Presenting Your Case to a Reviewer 25

4 Presenting an Inpatient Case 39

5 Presenting a Partial Hospital Case 53

6 Presenting a Substance Abuse Case 67

7 Fundamentals of Clinical Documentation 91

8 Documenting an Individual Patient's Care 105.

Notes:

Includes bibliographical references and index.

ISBN:

1585620424

OCLC:

48093203