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

Book by Browning, Charles H., Browning, Beverly J., Ph.D.

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-IVTM, 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.

"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 '90s." --Venus S. Masselam, Ph.D. President, Middle Atlantic Division American Association of Marriage and Family Therapy

"Prior to owning this book, I had some treatment reports returned. With the help of the book, I rewrote the reports, and they were fine. . . . A gem of a book--I have been praising it to other therapists . . . it is indispensable!"

"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. President, Santa Clara Chapter California Association of Marriage and Family Therapy

"Now I know who those flies on the wall were--the Brownings! They really get into the mind of a case manager . . . the book is a must for all clinicians." -- Carol Kryder, M.A., M.F.C.C., C.M.F.T. Case Manager

"Excellent, comprehensive, and thorough." -- Richard H. Small, M.D. Value Behavioral Health, Bellevue, Washington

"This 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 only going to buy one book on managed care, this is the one to buy!" --Rose Piper Practice Marketing Consultant and Training Specialist