Negotiating Managed Care: A Manual for Clinicians by Michael A. Fauman (Paperback, 2001)

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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. The goal of this text 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, the author demonstrates how to: present effective requests for inpatient, partial hospital, and substance abuse care; negotiate with a reviewer to get approval for your patient's care; respond when you and the reviewer disagree; write clinical notes that substantiate your request for care; deal with unethical reviewers and managed care companies; and appeal denials of care. 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.

Product Identifiers

PublisherAmerican Psychiatric Association Publishing
ISBN-139781585620425
eBay Product ID (ePID)95714685

Product Key Features

Number of Pages128 Pages
Publication NameNegotiating Managed Care: a Manual for Clinicians
LanguageEnglish
SubjectPsychology, Healthcare System
Publication Year2001
TypeTextbook
AuthorMichael A. Fauman
FormatPaperback

Dimensions

Item Height229 mm
Item Weight254 g
Item Width150 mm

Additional Product Features

Country/Region of ManufactureUnited States
Title_AuthorMichael A. Fauman
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