The Preferred Provider's Handbook


Book Description

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.




Mental Health Providers Guide To Managed Care


Book Description

For both patients and providers, the words managed care are loaded with negative connotations, synonymous with inefficiency and bureaucracy. Forced to perform a delicate balancing act of offering the best possible care for their clients while carefully adhering to various managed care policies and procedures, providers in particular often wince at the prospect of having to deal with managed care companies, or MCOs. Fearing burdensome paperwork, low reimbursement rates, and denials of care, it's not surprising that a number of mental health professionals choose to limit their involvement with managed care companies-or eliminate it altogether. "My clients are all on different health plans; how can I keep the policies straight?" "Getting services approved is so time-consuming that I'm better off accepting only self-paying clients, aren't I?" "Do the benefits of working with MCOs really outweigh the drawbacks?" The answer, according to two industry insiders, is yes. If you know how to work with the system, the system can work for you. Mental Health Provider's Guide to Managed Care is the first handbook of its kind to offer clinicians a window into the inner-workings of MCOs. Authors Reich and Kolbasovsky candidly draw on their combined 37 years experience in the field to walk readers through all the major elements of how to successfully work within the system: marketing yourself and your practice to an MCO, getting onto a MCO's network, maintaining a good relationship and communicating with MCOs for quick service approval, reducing your liability, understanding your rights and responsibilities, getting paid, and more. Every issue—big and small—is covered, from capitation versus fee-for-service payment arrangements to evaluating which MCOs are a good fit to join, and everything in between. After explaining how to work with the system, the authors reveal how to put the system to work for you. Tips for building your practice through referrals, generating business through doctor collaboration, and understanding future practice opportunities are all covered.By demystifying the complexities of managed care and offering a unique, inside view of the process, this book mitigates the negative connotations associated with MCOs and exposes the hidden benefits of a seemingly burdensome process. Exceedingly reader-friendly and packed with insightful tips and vignettes, Mental Health Provider's Guide to Managed Care is one clinician's guide you won't want to be without.




The Medicare Handbook


Book Description




Handbook of Healthcare System Scheduling


Book Description

This edited volume captures and communicates the best thinking on how to improve healthcare by improving the delivery of services -- providing care when and where it is needed most -- through application of state-of-the-art scheduling systems. Over 12 chapters, the authors cover aspects of setting appointments, allocating healthcare resources, and planning to ensure that capacity matches needs for care. A central theme of the book is increasing healthcare efficiency so that both the cost of care is reduced and more patients have access to care. This can be accomplished through reduction of idle time, lessening the time needed to provide services and matching resources to the needs where they can have the greatest possible impact on health. Within their chapters, authors address: (1) Use of scheduling to improve healthcare efficiency. (2) Objectives, constraints and mathematical formulations. (3) Key methods and techniques for creating schedules. (4) Recent developments that improve the available problem solving methods. (5) Actual applications, demonstrating how the methods can be used. (6) Future directions in which the field of research is heading. Collectively, the chapters provide a comprehensive state-of-the-art review of models and methods for scheduling the delivery of patient care for all parts of the healthcare system. Chapter topics include setting appointments for ambulatory care and outpatient procedures, surgical scheduling, nurse scheduling, bed management and allocation, medical supply logistics and routing and scheduling for home healthcare.







A Guide to Supply Chain Management


Book Description

Managing supply networks for innovation and competitive advantage: Concepts, models, roadmaps, and more Capture, organize, and fully utilize your #1 supply chain resource: knowledge Systematically improve strategic, tactical, and operational decision-making Improve your capabilities for managing and competing on supply networks Best-practice supply chain management transcends yesterday's functional silos. Today, it requires a comprehensive approach that recognizes supply networksas the core driver of business value. To maximize and sustain value creation in fast-changing supply networks, practitioners must properly address an even deeper issue: knowledge. In A Guide to Supply Chain Management, two pioneers in global supply chain operations explain why knowledge management is so critical to supply chain success. This comprehensive introductory guide offers powerful blueprints and models for managing both knowledge and risk in your own rapidly evolving environment. Using the new approaches described here, supply chain decision-makers can systematically achieve far higher levels of effective innovation. This innovation will help you create a ground-breaking cost-benefit environment: one that encompasses partners and alliances to establish sustainable competitive leadership. The book discusses models such as the Forrester ́s Effect, the Efficient Supply Chain, Vendor managed inventory (VMI), Lean supply chain, Sales and operations planning (S&OP), Continuous replenishment program (CRP), the Agile supply chain, Efficient consumer response (ECR), Collaborative planning, forecasting and replenishment (CPFR), Responsive supply chain, Bullwhip effect, Leagile supply chain, Supply chain risk management, Integrated Business Planning (IBP), Resilient supply chain, Customer driven supply chain, Demand driven supply chain, Business Case, Adaptive supply chain, and the wise supply chain.







The Physical Therapist's Guide to Health Care


Book Description

The Physical Therapist's Guide to Health Care is the simple, clear approach to understanding health care in today's changing environment. This book provides a strategy based approach to help physical therapists successfully manage change and meet the challenges of clinical practice in common practice settings. This essential text includes an introduction to health care that covers the basics of health care financing, health care reimbursement systems, cost containment strategies and referral services. Important issues covered in this book include trends in acute, subacute, home health care practice, outcomes management and prevention. Chapters include information on health care reimbursement systems and cost containment strategies, time and caseload management, documentation requirements, quality management in physical therapy, and the role of the physical therapist in prevention and wellness. Check out our new website dedicated to The Physical Therapist's Guide to Health Care. This innovative new website presents valuable up-to-date information as it becomes available. You can visit the site at ptguide.slackinc.com Dr. Kathleen A. Curtis is the winner of the “President’s Award of Excellence” for 2005 at California State University, Fresno