The Preferred Provider's Handbook

The Preferred Provider's Handbook

Author: William L. Poynter

Publisher: Routledge

Published: 2013-10-28

Total Pages: 188

ISBN-13: 1135063842

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First published in 1994. A revolution has been taking place in behavioral health financing, and only those practitioners who know how to successfully market themselves to managed care organizations are likely to maintain their hold in this rapidly changing system. Realistic, clear, insightful and highly practical, The Preferred Provider's Handbook will help therapists to understand the managed care marketplace and to develop the strategies necessary to meet its many challenges. You will learn how to: Get accepted on preferred provider lists of managed care organizations (M.C.O.s); Generate patient referrals once you are accepted onto a panel of preferred providers; Retain active referral status over the long term; Zero in on the higher quality networks that produce higher income and have minimal legal risk; Break into closed provider lists-one of the most difficult but important tasks. The Handbook clearly sets forth the basics of managed care with the aim of helping psycho therapists gain an understanding and acceptance of this new system. The volume addresses strategic marketing, whereby therapists can select and pursue those managed care organizations best suited to their needs; provides tools for designing and implementing a marketing plan; and gives a framework for understanding and making profitable use of future trends-in a profes sional and ethical manner. Of particular value is a chapter discussing marketing implications for behavioral health arising from the Clinton administration's new "managed competition" plans. Armed with specific information on how to fill out an M.C.O. application, how to analyze a contract, which specialties are most desirable and which should be avoided, how to network, and much, much more, you will be well on your way to professional success. This is an essential resource for all practitioners in the managed care marketplace.


Managed Behavioral Health Care Handbook

Managed Behavioral Health Care Handbook

Author: E. Clarke Ross

Publisher: Jones & Bartlett Learning

Published: 2001

Total Pages: 426

ISBN-13: 9780834217270

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Written by a team of nationally recognized authorities on managed care, Managed Behavioral Health Care Handbook guides you through specific strategies that characterize contemporary efforts made at managing behavioral health care, building a clear understanding of their role, and their effect in improving the quality of behavioral health care today, and in the future. From beginning to end, you will learn the core components of the managed behavioral health care process and gain invaluable insight into the numerous controversies and public policy issues.


The Preferred Provider's Handbook

The Preferred Provider's Handbook

Author: Rachelle A. Dorfman

Publisher: Psychology Press

Published: 1994

Total Pages: 188

ISBN-13: 9780876307083

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First Published in 1994. Routledge is an imprint of Taylor & Francis, an informa company.


The Clinician's Guide to Managed Behavioral Care

The Clinician's Guide to Managed Behavioral Care

Author: William Winston

Publisher: Routledge

Published: 2014-02-04

Total Pages: 356

ISBN-13: 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 Clinician's Guide to Managed Behavioral Care

The Clinician's Guide to Managed Behavioral Care

Author: Norman Winegar

Publisher: Psychology Press

Published: 1996

Total Pages: 356

ISBN-13: 9780789060129

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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


Managing Managed Care

Managing Managed Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1997-04-21

Total Pages: 394

ISBN-13: 0309175054

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Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.


Handbook of Quality Management in Behavioral Health

Handbook of Quality Management in Behavioral Health

Author: George Stricker

Publisher: Springer Science & Business Media

Published: 2013-11-11

Total Pages: 410

ISBN-13: 1461541956

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For the first time in history, behavioral health providers are expected to understand and participate in activities intended to access and improve the quality of services they provide. This handbook is designed as a general resource in the field of behavioral health quality management for a very diverse group of readers, including graduate and undergraduate students, payors, purchasers and administrators within managed care organizations, public sector service system planners and managers, applied health services researchers and program evaluators. This volume provides a comprehensive context for the development of quality management (QM) in health services - behavioral health in particular - as well as an overview of tools, techniques, and programs reflecting QM in practice. It also offers perspectives on both internally- and externally-based QM activities.


Handbook of School Mental Health

Handbook of School Mental Health

Author: Mark D. Weist

Publisher: Springer Science & Business Media

Published: 2008-10-23

Total Pages: 389

ISBN-13: 0387733132

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Turn to this book for practical guidance in attending not only to routine mental health needs of students, but also in responding quickly and effectively to traumatic events. The authors discuss how to build and enhance collaborative approaches among the many stakeholders. You’ll learn how to ensure that best evidence-based practices are used in all systems of care. Next, the handbook introduces strength-based approaches to assessment in schools. Finally, the authors discuss the latest strategies to help you prevent and manage crises while addressing the unique ethical, cultural, and legal challenges of school mental health.


Managed Mental Health Care in the Public Sector

Managed Mental Health Care in the Public Sector

Author: Kenneth Minkoff

Publisher: Psychology Press

Published: 1997

Total Pages: 360

ISBN-13: 9789057025372

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The rapid spread of managed care into public and community mental health systems is creating a dramatic transformation of traditional public sector settings. This radical change is affecting administrators, managers, and clinicians.Intended as a survival manual, this book begins with an overview of the history, concepts, ideology, and ethics of public sector managed care and then proceeds in focus from system to program management to clinical program levels. With a concluding section on advocacy, evaluation, research, and training issues, Managed Mental Health Care in the Public Sector examines how public sector managed mental health care can be approached with a positive spirit, an excitement about the potential to create dramatic and beneficial system changes, and a genuine interest in investigating the relative merits of every aspect of managed care systems.


Handbook of Clinical Psychology in Medical Settings

Handbook of Clinical Psychology in Medical Settings

Author: Ronald H. Rozensky

Publisher: Springer Science & Business Media

Published: 2013-06-29

Total Pages: 636

ISBN-13: 1461537924

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For two decades, I have been responding to questions about the nature of health psychology and how it differs from medical psychology, behavioral medicine, and clinical psychology. From the beginning, I have taken the position that any applica tion of psychological theory or practice to problems and issues of the health system is health psychology. I have repeatedly used an analogy to Newell and Simon's "General Problem Solver" program of the late 1950s and early 1960s, which had two major functional parts, in addition to the "executive" component. One was the "problem-solving core" (the procedural competence); the other was the representa tion of the "problem environment. " In the analogy, the concepts, knowledge, and techniques of psychology constitute the core competence; the health system in all its complexity is the problem environment. A health psychologist is one whose basic competence in psychology is augmented by a working knowledge of some aspect of the health system. Quite apparently, there are functionally distinct aspects of health psychology to the degree that there are meaningful subdivisions in psychological competence and significantly different microenvironments within the health system. I hesitate to refer to them as areas of specialization, as the man who gave health psychology its formal definition, Joseph Matarazzo, has said that there are no specialties in psychology (cited in the editors' preface to this book).