The purpose of this paper is to inform professionals in the process of becoming a provider for a managed care organization. Many counselor join manage care organization to be able to provide services to the individual using a certain type of insurance. However there are benefits of being a part of a managed care organization. The role managed care companies have on counselor providing treatment can cause limitations for the counselor. The purpose of managed care organizations is cost control, delivery of quality care and cost effective treatment access to enrollees (Lawless, 1999).
The benefits of a managed care organization are the following: controlled cost of services, access to needed mental health care, increases in the number of referrals for some practitioners, creation of quality control and standards of practice.
The United States have been focusing on balancing the coverage for substance abuse and mental health individuals’ in general medical care. Cost sharing have not been addressed by the Federal Law which would discourage needed care or be a burden on enrollees financially. In a study conducted in 1999 on cost sharing requirement for outpatient care in managed care plans, found that 40% of products required a copayment of $20 dollars of more while 15% of products required a coinsurance of 50%. However the cost sharing for substance abuse treatment was about the same for outpatient for mental health. When contrasted to the general medical care about 30 percent of products required higher cost sharing for substance abuse and mental health treatment (Hodgkin, 2003).
However quality is a problem that have been not been dealt with by current managed care models according to Cummings et ...
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...in good standing with the authorities and programs state and the federal. The professional must be free of any current illegal substance or drug use.
Furthermore, if a professional is a member of an unaccredited organizations will be required a site visit. When Value Option conducts the site visit at the professional office or locations there would be an evaluations using their site and operations standards against their standards. Also there would be an evaluations of clinical recordkeeping practices against their standards. The site visits will consist of sex visits
Part 4: Reflection
I think about managed care organization, I think I might would want to be a provider for such an organization. I’ll be able to network among other in my profession. result of this course. Be sure to address elements listed in your assignment directions and link the content to
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