0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Open Forum   |    
Optimizing Managed Care Peer Reviews: Turning a “Doc to Doc” Talk Into Better Advocacy for Psychiatric Inpatients
Stuart L. Lustig, M.D., M.P.H.; Alvin R. Blank, M.D.; Robert J. Cirelli, M.D.; Sara R. Friedman, Ph.D.; Frederick C. Green, M.D.; William M. Lopez, M.D., C.P.E.; Anthony G. Massey, M.D.; Douglas A. Nemecek, M.D., M.B.A.; Kathleen J. Papatola, Ph.D.; Narendra H. Patel, M.D., J.D.; Mohsin Qayyam, M.D.; Vikram N. Shah, M.D., M.B.A.; Anil Sipahimalini, M.D.; Victoria C. Shampaine, M.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.004202012
View Author and Article Information

The authors are affiliated with Cigna Behavioral Health at various U.S. locations. Send correspondence to Dr. Lustig (e-mail: stuart.lustig@cigna.com).

Copyright © 2013 by the American Psychiatric Association

Abstract

Clinicians often resent behavioral health managed care peer reviews. However, such reviews need not be onerous. This Open Forum, written by managed care physician reviewers, attempts to help attending psychiatrists, specifically those on inpatient units, achieve more satisfying outcomes for patients by adhering to a few basic principles. Beyond the level-of-care guidelines, attending psychiatrists are advised to focus on immediate acuity, along with specific life events that may have immediate impact on the patient’s well-being. A clear diagnosis, relevant treatment plan, salient updates, and strategies for preventing readmission can justify additional treatment time. By contrast, “time-based treatments,” dispositional issues, or a patient’s lack of acceptance or effective use of treatment are harder to justify.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

+

References

Lazarus  A:  Equitable peer review.  Psychiatric Services 49:1535–1539, 1998
[PubMed]
 
Schechter  D:  Tips to help take the hassle out of inpatient utilization review.  Family Practice Management 8:33–36, 2001
[PubMed]
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Articles
Books
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 1.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 31.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles
Medicaid managed care for mental health services in a rural state. J Health Care Poor Underserved 2005;16(3):497-514.