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* File claims that get paid
* Get more sessions for your clients
* Take the stress out of communicating with managed-care companies
* Promote 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" contract
* Challenging fee reductions
* Writing treatment reports in "managed-care- friendly" language to enhance the likelihood of obtaining continued authorization
* The nuts and bolts of "medical necessity"
* Effectively fighting denials of care
* Getting 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?
