How to Partner with Managed Care: A

How to Partner with Managed Care: A "Do-It-Yourself Kit" for Building Working Relationships and Getting Steady Referrals

by Charles H. Browning, Beverley J. Browning
     
 

How to Partner with Managed Care According to one high-level managed care executive, healthcare providers face a Darwinian struggle over the next few years. "In today’s highly competitive healthcare environment, the weaker players are being forced out.… The ‘shakeout’ is already under way. The number of players in the competitive arena will

Overview

How to Partner with Managed Care According to one high-level managed care executive, healthcare providers face a Darwinian struggle over the next few years. "In today’s highly competitive healthcare environment, the weaker players are being forced out.… The ‘shakeout’ is already under way. The number of players in the competitive arena will be fewer, but those remaining will be strong." This change is particularly dramatic for mental health professionals, who must not only adapt to new ways of obtaining referrals, submitting paperwork, and securing payment authorization, but who also face fundamental changes in the nature of the services they provide and how the delivery of those services is planned, documented, and reported. This expanded edition of Charles and Beverley Browning’s strategy-filled bestseller is the mental health professional’s guide to every aspect of the uncharted world of managed care. Updated for the DSM-IV, it demonstrates in simple language how to get on provider panels, receive regular referrals from case managers, and handle phone contacts confidently and persuasively. The Brownings provide strategies and methods for writing successful treatment plans that win session approval and extension of treatment for your clients. They offer a short course in effective brief therapy—the approach preferred by managed care organizations—and show you how to convincingly demonstrate the high quality of your services through simple outcomes research. You’ll also learn techniques that will help you establish strong relationships with case managers and utilization reviewers and become a trusted, busy preferred provider:

  • The 12 "musts" case managers want from you—do them and get more referrals
  • The 12 most common mistakes that can damage your practice, and how to avoid them
  • Simple ways to get to the top of case managers’ preferred provider lists
  • Proven ways to introduce yourself to managed care companies, including sample practice profile criteria and letter formats
  • Strategic examples of treatment plans that work
  • Tips from experts on automating your practice to make it responsive to managed care—today and tomorrow
  • A comprehensive glossary of managed care terms and phrases
  • A user-friendly regional directory of major managed care organizations
Written by clinicians, for clinicians, this valuable reference tool for practice and program survival helps you adapt your talents, skills, and abilities to grow and thrive in a new era of behavioral healthcare.

Editorial Reviews

Booknews
A reference for mental health clinicians, offering strategies for thriving in the new era of behavioral healthcare. Gives advice on getting referrals, writing treatment plans that win approval for extension of treatment, and demonstrating the quality of services through outcomes research, and outlines the basics of brief therapy. Explains what case managers want and how to give it to them, and how to automate a practice for managed care. Includes a glossary and a regional directory of major managed care organizations. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Product Details

ISBN-13:
9780471157519
Publisher:
Wiley
Publication date:
01/28/1996
Edition description:
Expanded Edition
Pages:
366
Product dimensions:
6.46(w) x 9.57(h) x 1.26(d)

What People are saying about this

Piper
RoseThis resource is a classic! It incorporates timeless, business strategies and principles that have been tested and proven effective all over the country. It is a tool that should be on every therapist's bookshelf. If you are going to buy one book on managed care this is the one to buy.
—Rose Piper, Practice Marketing Consultant and Training Specialist
Carol Crayder
Now I know who those flies on the wall were - The Brownings! They really get into the mind of the case worker…the book is a must for all clinicians.
Marti Baerg
The upbeat style and terrific detailed organization of this book made the necessary chore of learning more about managed care surprisingly pleasant and manageable…It made it easy for me to find the answers to my questions.
— Marti Baerg, M.A., M.F.C.C.
Venus S. Masselam
I found the text wonderfully easy to read. It's totally practical, with clear examples of hands on approaches for dealing with managed care and the people who manage it. A substantial survival kit for private practitioners in the nineties.
—Venus S. Masselam, PhD.

Meet the Author

Drs. CHARLES and BEVERLEY BROWNING are co-directors of the Browning Therapy Group, Inc., a multispecialty group behavioral healthcare practice in southern California. They also conduct training programs and seminars on practice-building strategies and provide practice-development consultation to professionals throughout the United States. Their popular text Private Practice Handbook, now in its fourth edition, is an indispensable reference for clinicians in private practice worldwide.

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