| Description |
1 online resource (347 pages) |
| Contents |
Cover; Half Title; Title Page; Copyright Page; Table of Contents; Acknowledgments; Introduction; Chapter 1. What Is "Managed Care"?; Essential Facts; Background: Developments that Set the Stage for Managed Behavioral Care Systems; Risk: The Dynamic that Drives Managed Care; Chapter 2. Managed Care Basics: Health Maintenance Organizations; The Central Role of the Primary Care Physician; Other Key HMO Functions; HMO Models; Internal Organizational Structures; Quality Assurance and Regulation; Current Trends; Summary |
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Chapter 3. Preferred Provider Organizations and Mental Health Point-of-Service NetworksHow PPOs Achieve Cost Containment; Other Features; Provider Selection; Discussion and Trends; Point-of-Service Networks; Any Willing Provider Statutes; Chapter 4. Employee Assistance Programs and Managed Care; Background and Development; How EAPs Work; Basic Delivery Systems; EAP Staffing; Do EAPs Create a Return on Investment?; Future Trends; EAP Retooling; Chapter 5. Managed Behavioral Care Systems; Understanding Managed Care Product Lines; Values and Beliefs Associated with MBC; Elements of MBC Systems |
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Key Administrative Aspects of MBC SystemsIndustry Consolidation; Trends; Chapter 6. Contracting with Managed Care; Contracting with Closed Networks; Risk-Based Contracting; Chapter 7. Managing the Utilization Management Process; Types of UM Procedures; Typical UM Questions; Medical Necessity; Denials, Appeals, and Other UM Aspects; Chapter 8. Legal Issues and Utilization Management; Major Cases; Implication for Employers; State Regulations and ERISA; Summary; Chapter 9. Marketing to Managed Care; Implications for Clinicians; Outpatient Practice |
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Managed Care-Hospital Partnerships: Implications for Substance Abuse TreatmentSummary; Chapter 10. Critical Issues; Important MBC Features for Consumers; EAPs and Managed Care; Quality of Services; Ethical Issues for Practitioners; Appendix A. Mental Health Provider Agreement; Appendix B. Directory of America's Health Maintenance Organizations; Appendix C. Treatment Summary; Appendix D.S.O.A.P. Process Note Recording Format; Appendix E. Managed Care Directory, 1995; Appendix F. Brief Therapy Reading List; Appendix G. Managed Care Market Share Estimates, 1995; Glossary; Index |
| Summary |
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 clinician |
| Notes |
Print version record |
| Subject |
Managed mental health care -- United States
|
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Managed mental health care
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United States
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| Form |
Electronic book
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| Author |
Winegar, Norman
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| ISBN |
9781317786290 |
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1317786297 |
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