Download or read book Utilization Management written by American Psychiatric Association. Committee on Managed Care and published by American Psychiatric Pub. This book was released on 1992-01-01 with total page 84 pages. Available in PDF, EPUB and Kindle. Book excerpt: This handbook provides clinicians with timely and useful information that will help psychiatrists obtain optimal coverage of services for patients. Among the issues addressed are frequently encountered problems, confidentiality, contracting, and the process of utilization management.
Download or read book Guidelines for Psychiatric Utilization Review in Community Mental Health Centers written by Psychiatric Utilization Review and Evaluation Project and published by . This book was released on 1975* with total page 126 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Study Documenting the Initial Impact in Establishing Psychiatric Utilization Review Mechanisms in Four Participating Community Mental Health Centers written by Carl Anthony Cappello and published by . This book was released on 1974 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Psychiatric Utilization Review written by Gary L. Tischler and published by . This book was released on 1972* with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Psychiatric Utilization Review written by and published by . This book was released on 1968 with total page 54 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Psychiatrist s Managed Care Primer written by American Psychiatric Association. Office of Economic Affairs and Practice Management and published by American Psychiatric Pub. This book was released on 1997 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt: Because an increasing number of patients are covered through managed care plans, psychiatrists need to understand the managed care system in order to answer their patients' questions and ensure the continued prosperity of their practices. To assist clinicians in these challenging times, The Psychiatrist's Managed Care Primer arms psychiatrists with the information and tools they need to flourish within the managed care environment while simultaneously delivering quality patient care. This monograph provides an overview of the evolution of this industry; detailed explanations of current managed care models, operations, and anticipated trends; and practical advice on key problem areas. It focuses on the pressing issues of utilization management and capitation as well as important regulatory, ethical, and legal issues psychiatrists confront under this system. The potential impact that managed care systems have on their patient referrals, clinical decision-making autonomy, and income is also examined closely. Equipped with the sophisticated understanding of managed care supplied by this primer, psychiatrists can make the important decisions that will ensure the survival of their practice.
Download or read book Mastering Utilization Review written by Lauro Amezcua Patino Fapa, MD and published by Independently Published. This book was released on 2023-08-13 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Utilization review is a pivotal process in inpatient psychiatry for adolescents and adults, playing a critical role in evaluating the necessity, appropriateness, and efficiency of healthcare services. This book offers physicians a comprehensive insight into utilization review, connecting healthcare providers and insurance companies. Key areas covered include medical necessity, treatment planning, length of stay, and navigating appeals and denials. By mastering these aspects, physicians can ensure optimal patient care while safeguarding against unnecessary treatments, thus enhancing the financial stability of their practice.The detailed guidance within the book covers how to effectively document medical necessity, develop evidence-based treatment plans tailored to each patient's needs, and strategize the length of stay based on clinical indicators. Additionally, it provides a roadmap for successful appeals in case of denials. This knowledge is crucial for physicians to optimize insurance coverage and reimbursement, avoiding premature discharges, and subsequent denials.In sum, the book serves as a vital tool for inpatient psychiatric practitioners, offering the knowledge and tools necessary to navigate the complex landscape of utilization review. It strikes a careful balance between patient needs, ethical treatment, and financial considerations, ensuring that the right care is provided without excess, and contributes significantly to the broader discourse on healthcare efficiency and responsibility.
Download or read book Development of a Utilization Review System for the South Shore Mental Health Center written by Margaret V. Hegarty and published by . This book was released on 1990 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Guide to Utilization Review for Psychiatric Hospitals written by and published by . This book was released on 1968 with total page 31 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Psychiatric Utilization Review Program in Western Pennsylvania written by C. Patrick Hardwick and published by . This book was released on 1972 with total page 376 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Hospital Guide to Contemporary Utilization Review written by Stefani Daniels and published by . This book was released on 2015-04-16 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives
Download or read book Psychiatric Utilization Review and Evaluation Project written by and published by . This book was released on 1972* with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Quality Assurance in Mental Health written by National Institute of Mental Health and published by . This book was released on 1982 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Psychiatric Clinical Pathways written by Patricia C. Dykes and published by Jones & Bartlett Learning. This book was released on 1998 with total page 308 pages. Available in PDF, EPUB and Kindle. Book excerpt: The only reference tool of its kind for psychiatric health care professionals and agencies, Psychiatric Clinical Pathways: An Interdisciplinary Approach gives a wealth of practical guidance and useful real-world models you can put to work immediately. You and your staff will discover the many ways clinical pathways can be used to deliver cost-effective, quality care in a variety of settings. You'll benefit from useful models of outcomes-based care delivery systems, and practical guidelines For The delivery of quality health care and continuous quality improvement. This book is packed with information you can use immediately, including a bonus Clinical Pathways Diskette -- packed with formats and checklists your can customize to meet your needs.
Download or read book The Clinician s Guide to Managed Behavioral Care written by William Winston and published by Routledge. This book was released on 2014-02-04 with total page 347 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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
Download or read book The CHAMPUS Utilization Review and Quality Assurance System for Psychiatric mental Health Benefits written by John G. Meyer and published by . This book was released on 1977 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managing Managed Care written by Institute of Medicine and published by National Academies Press. This book was released on 1997-04-21 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
