Manage authorizations to manage care

Managed care organizations rely on different ways to authorize the utilization of hospital services, physician specialty care and other referral services. Critical differences revolve around the role the primary care physician plays in the authorization process. The more tightly managed the system,...

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Bibliographic Details
Published in:Nursing management 1996-10, Vol.27 (10 Suppl), p.10-12
Main Author: Grimaldi, P L
Format: Article
Language:English
Subjects:
Beneficiaries
Capitation
Cost control
Cost Savings
Health care expenditures
Health maintenance organizations
HMOs
Hospitalization
Hospitals
Humans
Managed Care Programs - organization & administration
Medical referrals
Medicare
Nursing
Physicians, Family
Primary care
Referral and Consultation - organization & administration
Utilization Review - organization & administration
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Summary:Managed care organizations rely on different ways to authorize the utilization of hospital services, physician specialty care and other referral services. Critical differences revolve around the role the primary care physician plays in the authorization process. The more tightly managed the system, the more likely unnecessary medical costs will be avoided.
ISSN:0744-6314
1538-8670