3 edition of psychiatrist"s guide to managed care contracting found in the catalog.
Includes bibliographical references (p. 69-70).
|Statement||American Psychiatric Association, Office of Economic Affairs and Practice Management.|
|Contributions||American Psychiatric Association. Office of Economic Affairs and Practice Management.|
|LC Classifications||RC465.6 .P779 1997|
|The Physical Object|
|Pagination||75 p. ;|
|Number of Pages||75|
|LC Control Number||97012315|
Managed Care in Medicare. From a certain point of view, the managed care revolution never gained a firm grip on Medicare. While in the commercial sector, among employer-sponsored individuals with health care coverage, a mere 5 percent are in non-managed care arrangements (Kaiser Family Foundation/Health Research and Educational Trust, ), Medicare continues . Managed care is "an organized system of care which attempts to balance access, quality, and cost effectively by using utilization management, intensive case management, provider selection, and cost-containment methods" (CSAT, d). Despite the antipathy that many public sector health care providers feel toward managed care, those providers are actually striving toward .
In providing a historical survey of the development of managed care, the authors state “If we in the mental health field had been clairvoyant and initiated regulatory and cost-cutting steps from within (an admittedly difficult thing to do), we might have held off the surge of managed care, but not necessarily” (Sperling et al., , p. 21). This new book brings together the nation's top psychiatrists and attorneys to give you--the practicing psychiatrist--a detailed roadmap through the minefield of malpractice risk management. Here are just a few of the thought-provoking and enlightening authors and their topics: * Lawrence L. Kerns, MD, and Carol Gerner, JD, advise you on the timely topic of avoiding liability in managed care.
This book is a guide to strategic training for physicians in an era of managed care. The first half of the book provides a step-by-step process to help physicians take their practices into the new world of integrated delivery systems. The second half of the book covers a variety of key topics such as credentialing, reimbursement systems, and utilization management. Doral has written numerous articles on medical practice revenue cycle, managed care contracting and payment reform and is a frequent speaker at national, regional and local healthcare forums. Doral is a co-author of MGMA’s book, Transitioning to Alternative Payment Models: A Guide to Next Generation Managed Care Contracting, published in.
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Summary: The book 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.
psychiatrists guide to managed care contracting book Maria Todd's The Managed Care Contracting Handbook is a must-have book for the non-attorney health care professional negotiating managed care contracts for providers. Todd combines a thorough discussion of managed care contracting basics with helpful hints and practical tools for contracting with all types of payor organizations all /5(11).
The book provides the tools that will allow clinicians to navigate this process and develop a successful capitated program. The guide contains advice on how to calculate a capitation rate, evaluate and negotiate a contract, minimize the financial risks involved, and resolve numerous other issues crucial to a successful capitation contract.
View a sample of this title using the ReadNow feature. If you are not an AHLA member and would like to purchase this book, click here. The Health Plans Contracting Handbook, Seventh Edition from AHLA traces the managed care contracting process from preparing to negotiate the contract, to formation and implementation, to termination issues.
It identifies key questions. Prologue: While the entire physician workforce is experiencing profound changes brought about by the growth of managed care, psychiatry faces some unique challenges. Psychiatrists Cited by: Business Strategy Development: The Psychiatrist's Guide to Managed Care Contracting.
Washington, DC, American Psychiatric Press, Google Scholar. Pollard M, Tilson HH: Legal and regulatory issues in managed behavioral healthcare, in The Complete Guide to Managed Behavioral Healthcare.
Edited by Stout C, Theis E, Ober J. and vetted by the Managed Care Contracting (MCC) We present “book ends” to MCC The recommended strategy is brought to the LCPN Board for approval Negotiation updates are given to the MCC “Completed” negotiations are presented and the MCC makes a recommendation to accept or deny the proposed contract terms to the LCPN Board.
Psychiatrist’s Guide to Practice Management, The Psychiatrist’s Managed Care Primer, The Psychiatrist’s Guide to Capitation and Risk-Based Contracting, and Public Mental Health: A Changing System in an Era of Managed Care. We have provided a bibliography in the back of the handbook of the books we’ve.
MANAGED CARE CONTRACT PROVIDER WEBSITE. CLINICAL DOCUMENTATION AND BILLING STANDARDS* Quick Reference Guide for Specialty Mental Health Services February Fresno County MHP Clinical Documentation and Billing Standards – Quick Reference Guide for SMHS – February 2 Psychiatric Nursing Facility Services.
Practice Management for Psychiatrists: The Basics. An online reference guide for any APA member thinking of starting or changing a practice. Although specifically designed to meet the needs of resident-fellow members and early career psychiatrists, the information it contains may also be of value to those who have been in practice for years.
Today's practice of psychiatric administration is totally different from that in past years because of the vast changes sweeping the health care and behavioral health care sectors.
Reflecting these changes, this completely revamped second edition contains all-new chapters by 68 contributors (most new to this edition).This definitive textbook provides the practitioner and Reviews: 1. CareSource is an HMO with a Medicare contract. Enrollment in CareSource Medicare Advantage plans depends on contract renewal.
CareSource plans do not discriminate, exclude people or treat them differently, on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan.
Clinical Sleep Medicine A Comprehensive Guide for Mental Health and Other Medical Professionals Edited by Emmanuel H.
During, M.D., and. ManaGed CaRe StRuCtuReS Managed care takes a wide variety of forms and names, including the following common structures and models: Risk-based Managed Care Entities (MCEs) are contracted to provide and manage benefits.
In a full risk contract, the MCE, or managed care plan, agrees to provide all benefits on a per member per month basis. Telephonic Psychiatric Consultation Service Program (TiPS) of requires that state agencies contract with an External Quality Review Organization to conduct an annual external quality review of the services provided by contracted Medicaid Managed Care Organizations.
Under managed care, the state pays a managed care plan a capitation rate—a fixed dollar amount per member per month—to cover a defined set of services for each person enrolled in the plan. In turn, the plan pays providers for all of the Medicaid services an enrollee may require that are included in the plan’s contract with the state.
Member Managed Care Contracts Advisory Committee, Shands Hospital, University of Florida - Member Medicare Compliance Task Force, Department of Psychiatry. Provider Networks and Access to Care. Though research indicates that, overall, most primary care providers and specialists accept Medicaid, 1 provider participation in Medicaid is a subject of.
Medi‐Cal Managed Care Models • Two Plan Model:State contracts with 2 plans: a local initiative (locally developed and operated), and a commercial plan. Psychiatric and Psychotherapeutic Best Practices for Children: Birth Through Five Years of Age Support and Rehabilitation Services for Children, Adolescents, and Young Adults Attachment A, Support and Rehabilitation Services Desktop Guide.
This book is long overdue and will make a very large contribution to improving clinical care for residents of long-term care, and to making nursing home practice a viable option for both general and geriatric psychiatrists.—Soo Borson, M.D., President, American Association for Geriatric Psychiatry, Seattle, Washington.Pediatricians entering into managed care contracts need to take certain steps before signing a contract: assessing their readiness and the readiness of the practice for managed care; assessing the strengths and weaknesses of the managed care plans they are considering, and selecting a professional advisor to assist in the contracting process.
Nanci L. Robertson, MA Nanci Robertson is a healthcare consultant specializing in managed care contracting.
She has 30 years experience working in the healthcare field, with emphasis on negotiating managed care contracts on behalf of physicians, independent practice associations and ancillary s: 5.