Managed Health Care means any one of the alternative deliveries of regular fee-for-service Medicaid such as defined in subrules dealing with health maintenance organizations (HMOs), prepaid health plans (PHPs), or Medicaid Patient Access to Service System (MediPASS).
Managed Health Care means clinical and financial risk assessment and management of health care, with a view to facilitating appropriateness and cost effectiveness of relevant health services within the constraints of what is affordable, through the use of rules-based and clinical management- based programmes.
Managed Health Care plans such as HMOs and PPOs often require authorization before they provide reimbursement for mental health services. It may be necessary to seek approval by calling your insurance company for pre-approval prior to services being covered. If your carrier requires periodic updating of authorization for on-going sessions, it may be necessary for me to submit written treatment plans that include diagnosis and symptoms in order for them to authorize treatment. Should you choose to submit claims to your insurance company for reimbursement, your policy may require me to disclose this personal information to the company in the treatment plans, via phone inquiries from them and on the claim statements. If this office files claims for you, understand that in Maryland I am permitted to send some information without your consent. They usually require a clinical diagnosis, sometimes additional clinical information such as treatment plans, summaries, or copies of your record. In such situations, I will make every effort to release only the minimum personal information necessary for the purpose requested. Maryland law prevents insurers from making unreasonable demands for information, but there are no specific guidelines about what “unreasonable” includes. If I believe that your health insurance company is requesting an unreasonable amount of information, I will call it to your attention, and we can discuss what to do. You can instruct me not to send requested information, but this could result in claims not being paid and the financial responsibility being placed on you. Though all insurance companies claim to keep such information confidential, we have no control over what they do with it once it is in their hands or computers. By signing this agreement, you agree that I can provide requested information to your carrier. Your signature indicates that you have read, and understand, the information and the HIPAA notice form and agree to the terms described. Patient Signature Date Printed Name
Examples of Managed Health Care in a sentence
DHCS – California Department of Health Care Services DHHS – United States Department of Health and Human Services DMHC – California Department of Managed Health Care Dental Health Maintenance Organization (DHMO) – A type of dental plan product that delivers dental services by requiring assignment to a primary dental care provider who is paid a capitated fee for providing all required dental services to the Enrollee unless specialty care is needed.
State – The State of California State Regulators – California Department of Insurance and Department of Managed Health Care, as applicable.
Approval of the first recommendation will result in the execution of the Agreement (Exhibit I), and creation upon proper filing with the Secretary of State, of a JPA to seek a new health plan license from the Department of Managed Health Care to engage in the administration and operation of non- Medi-Cal managed care programs in Los Angeles County.
State and Federal Regulators – Department of Managed Health Care, California Department of Health Care Services, California Department of Insurance, US Department of Health and Human Services, and any other regulatory entity within the State of California that has jurisdiction over Contractor, as applicable.
More Definitions of Managed Health Care
Managed Health Care means any of the options for alternative delivery of Medicaid services that provides coordinated delivery of health care. The current options offered by the department are Medicaid patient management, known as MediPASS, health maintenance organization (HMO) enrollment and prepaid health plan (PHP) enrollment.
Managed Health Care plans such as HMOs and PPOs often require authorization before they provide reimbursement for mental health services. It may be necessary to seek approval by calling your insurance company for pre-approval prior to services being covered. If your carrier requires periodic updating of authorization for on-going sessions, it may be necessary for me to submit written treatment plans that include diagnosis and symptoms for them to authorize treatment. Should you choose to submit claims to your insurance company for reimbursement, your policy may require me to disclose this personal information to the company in the treatment plans, via phone inquiries from them and on the claim statements. If this office files claims for you, understand that in New York I am permitted to send some information without your consent. They usually require a clinical diagnosis, sometimes additional clinical information such as treatment plans, summaries, or copies of your record. In such situations, I will make every effort to release only the minimum personal information necessary for the purpose requested. New York law prevents insurers from making unreasonable demands for information, but there are no specific guidelines about what “unreasonable” includes. If I believe that your health insurance company is requesting an unreasonable amount of information, I will call it to your attention, and we can discuss what to do. You can instruct me not to send requested information, but this could result in claims not being paid and the financial responsibility being placed on you. Though all insurance companies claim to keep such information confidential, we have no control over what they do with it once it is in their hands or computers. By signing this agreement, you agree that I can provide requested information to your carrier. Your signature indicates that you have read, and understand, the information and the HIPAA notice form and agree to the terms described. Patient Signature Printed Name Date rev 05/24 CREDIT CARD AUTHORIZATION FORM Name: Email: Billing Address: Billing City: Billing State: Billing Zip: Billing Phone: Name on Credit Card: Credit Card Type: Visa MC AmEx Discover Credit Card Number: Credit Card AVS Code (3 or 4-digit code): Credit Card Expiration Date: (mm/yy) Cardholder Signature: Date:
Managed Health Care is the coordinated delivery of health care managed by a designated health care provider responsible for directing or monitoring such care.
Managed Health Care plans such as HMOs and PPOs may require authorization before they provide reimbursement for mental health services. These plans are sometimes limited to short-term treatment approaches designed to work out specific problems that interfere with a person’s usual level of functioning. It may be necessary to seek approval for more therapy after a certain number of sessions. You should also be aware that filing a claim with your health insurance company requires that I provide it with information relevant to the services that I provide to you. I am required to provide a clinical diagnosis. Sometimes I am required to provide additional clinical information such as treatment plans or summaries, or copies of your entire Clinical Record. In such situations, I will make every effort to release only the minimum information about you that is necessary for the purpose requested. This information will become part of the insurance company files and will probably be stored in a computer. Though all insurance companies claim to keep such information confidential, I have no control over what they do with it once it is in their hands. In some cases, they may share the information with a national medical information databank or your employer. Once we have all of the information about your insurance coverage, we will discuss what we can expect to accomplish with the benefits that are available and what will happen if they run out before you feel ready to end your sessions. It is important to remember that you always have the right to pay for my services yourself to avoid the problems described above.
Managed Health Care often requires authorization before they provide reimbursement for mental health services. These plans are often limited to short-term treatment approaches designed to work out specific problems that interfere with a person’s usual level of functioning rather than expanding or increasing the breadth of one’s experiential possibilities. It may be necessary to seek approval for additional therapy after a certain number of sessions, which the insurance company may or may not be willing to provide. Some managed- care plans will not allow me to provide services to you once your benefits end. If this is the case I will do my best to secure another provider who will help you continue with your psychotherapy. You should also be aware that your contract with your health insurance company requires that I provide it with information relevant to the services I provide to you. I am required to provide a clinical diagnosis. Sometimes I am required to provide additional clinical information such as treatment summaries, plans or even your entire clinical record. In such circumstances I will make every effort to release the minimal amount of information about you that is necessary for the purpose requested. This information will become part of the insurance company’s files and will probably be stored in a computer. Although all insurance companies claim to keep such information confidential, I have no control over what they do with it once it is processed by them. In some cases it is shared with a national information databank that other insurers may use in the future to determine your eligibility for health insurance, and in some cases people have been denied health coverage for having used mental health benefits. I will provide you with a copy of any report I submit, if you request it. By signing this agreement, you agree that I can provide requested information to your carrier. It is important to remember that you always have the right to pay for my services yourself to avoid the problems described above unless specifically prohibited by contract.
Managed Health Care plans such as HMOs and PPOs often require authorization before they provide reimbursement for mental health services. These plans are often limited to short-term treatment approaches designed to work out specific problems that interfere with a person’s usual level of functioning. It may be necessary to seek approval for more therapy after a certain number of sessions. While much can be accomplished in short-term therapy, some patients feel that they need more services after insurance benefits end. You should also be aware that your contract with your health insurance company requires that I provide it with information relevant to the services that I provide to you. I am required to provide a clinical diagnosis. Sometimes I am required to provide additional clinical information such as treatment plans or summaries, or copies of your entire Clinical Record. In such situations, I will follow HIPAA guidelines to release only the information that you have permitted me to convey to the insurance carrier. You should know that this information will become part of the insurance company files and will probably be stored in a computer. Though all insurance companies claim to keep such information confidential, I have no control over what they do with it once it is in their hands. In some cases, they may share the information with a national medical information databank. I will provide you with a copy of any report I submit, if you request it. By signing this Agreement, you agree that I can provide requested information to your carrier. It is important to remember that you always have the right to pay for my services yourself to avoid the problems described above.
Managed Health Care plans often require authorization before they provide reimbursement for mental health services. These plans are often limited to short-term treatment approaches designed to work out specific problems that interfere with a person’s usual level of functioning. It may be necessary to seek approval for more therapy after a certain number of sessions. Though a lot can be accomplished in short-term therapy, some Clients feel that they need more services after insurance benefits end. [Some managed-care plans will not allow Therapist to provide services once your benefits end. If this is the case, Kairos Counseling Inc. will try to assist in finding another provider who will help you continue your psychotherapy.] Client should also be aware that most insurance companies require that Therapist(s) provide them with Client’s clinical diagnosis. Sometimes Therapist(s) have to provide additional clinical information, such as treatment plans, progress notes or summaries, or copies of the entire record (in rare cases). This information will become part of the insurance company files. Though all insurance companies claim to keep such information confidential, Kairos Counseling Inc. or Therapist have no control over what they do with it once it is in their hands. In some cases, they may share the information with a national medical information databank. Client understands that, by using your insurance, Client authorizes Kairos Counseling to release such information to insurance company. Kairos Counseling Inc. will try to keep that information limited to the minimum necessary. Once Kairos Counseling Inc. has all of the information about your insurance coverage, Therapist will discuss what can be expected to accomplish with the benefits that are available and what will happen if they run out before Client feel ready to end our sessions. It is important to remember that Client always has the right to pay for my services him/herself to avoid the problems described above [unless prohibited by the insurance contract].