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.
Examples of Managed Health Care in a sentence
The patient manager will be responsible for attempting to correct uti- lization behavior of recipients who appear from utilization reports to be inappropriate utilizers of medi- cal services.88.51(3) Managed health care advisory committee.
Managed health care plans do not include any of the following: (i) Mental health plans contracting to provide mental health care for Medi-Cal beneficiaries pursuant to Chapter 8.9 (commencing with Section 14700).
For additional information view OAC 5160-26-02 Managed health care program: eligibility and enrollment and OAC 5160-26-02.1 Managed health care programs: termination of enrollment.
Managed health care plans such as EAPs, and PPOs often require authorization before they provide reimbursement for mental health services.
Managed health care plans such as HMOs and PPOs often require advance authorization before they will provide reimbursement for mental health services.
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. 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.
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 on 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 patients feel that they need more services after insurance benefits end. Some managed-care plans will not provide reimbursement once your benefits end. You should also be aware that most insurance companies require that therapists provide them with your clinical diagnosis. Sometimes therapists 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, Good Life Center for Mental Health, LLC has no control over their handling of protected health information. In some cases, they may share the information with a national medical information databank. It is important to understand that, by using your insurance, you are authorizing Good Life Center for Mental Health, LLC to release such information to your insurance company. Good Life Center for Mental Health, LLC will try to keep that information limited to the minimum necessary. Once we have all of the information about your insurance coverage, your therapist will discuss with you what you can expect to accomplish with the benefits. If your insurance benefits run out before you feel ready to terminate treatment, you have the option to continue with your therapist, or your therapist will try to assist you in finding another provider who will help you continue your psychotherapy. It is important to remember that you always have the right to pay for services yourself to avoid the problems described. Please note that your therapist will only respond to a request for information pertaining to your case, on your behalf, once he or she receives written notification from you, the patient or insured. Your therapist has opted-out of Medicare under §§ 1128, 1156 or 1892 of the Social Security Act. If you are eligible for Medicare but choose to work with a clinician who has opted-out of Medicare, then you will have to complete the Medicare Private Contract. Signing this contract indicates a...
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 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. 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 often require authorization before they provide reimbursement for mental health services. These plans may be limited to short-term treatment approaches designed for specific problems. 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 clients feel that they need more services after insurance benefits end. Some managed-care plans will not allow me to provide services to you once your benefits end. In this case, I will assist you in finding a provider who will help you continue your psychotherapy.
Managed Health Care plans such as HMOs and some PPOs often require authorization before they provide reimbursement for mental health services. These plans are sometimes oriented to short-term treatment approaches designed to address 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 clients feel that they need more services after insurance benefits end. At that point, unless prohibited by your insurance plan, you may continue therapy on a self-pay basis with me, or I will assist you in finding another therapist.