Publisher's Synopsis
File claims that get paidGet more sessions for your clientsTake the stress out of communicating with managed-care companiesPromote your clients' Confidentiality Learn to take charge of managed care A "how-to" guide for dealing with the everyday practice issues related to working with managed care. Written by an industry insider, Managing Managed Care offers a candid and unprecedented behind-the-scenes view, with focus on issues of vital importance to today's practitioner:Understanding the "participating-provider" contractChallenging fee reductionsWriting treatment reports in "managed-care- friendly" language to enhance the likelihood of obtaining continued authorizationThe nuts and bolts of "medical necessity"Effectively fighting denials of careGetting claims paid Managing Managed Care features insights from case managers, other managed-care employees in critical areas such as network, quality, consumer service, and managed- behavioral care company executives. Learn why they close the panels. Who gets the referrals, and why? How are managed-care and insurance companies shifting financial risk to practitioners? How is managed care itself changing as a result of market pressures?;What effect does NCQA have on managed-care companies? How does all this affect you and your clients, and what can you do about it?
