Distance Learning Course Catalog - Cicatelli Associates Inc.

Community Health Care Association of New York State
Managed Care in Community Health Centers

This course is no longer available on line

Description

Over the past 25 years, there has been a dramatic shift in health care insurance from the traditional fee for services model to the managed care model. State Medicaid programs have turned to managed care for delivering and paying for services. Managed care is not disappearing but is evolving. With economic and clinical changes, managed care has created challenges for the health care delivery system. This program will help health center staff to identify and address these challenges.

Goals & Objectives

This training program is designed to provide staff of community health centers (CHCs) with the tools they need to better manage the requirements of managed care plans. The central aims of the training are to help staff to:

Maximize the revenues CHCs receive from managed care plans.
Build and maintain cooperative relationships between health centers and health plans.

After completing this training program, participants will be able to:

1.		Describe basic managed care requirements including the authorization process, eligibility process, quality assurance process, and client encounter data.
2.		Develop methods and systems to ensure that the CHC maximizes managed care revenues.
3.		Educate patients about managed care rules, processes and procedures.

Development

This course was sponsored by Community Health Care Association of New York State (CHCANYS) with funding from the New York State Department of Health Workforce Retraining Initiative.

Developed by Cicatelli Associates Incorporated (CAI)

System Requirements

Windows 95 and above, Mac OS 9 and X.
Minimum of 64 MB of RAM.
Microsoft Word, Adobe Acrobat Reader.
Minimum 56K modem.
Browser - IE version 5 or higher, Netscape version 6 or higher.
Real One Player (to view videos)

Course Outline

Welcome	This section provides information regarding the development of this course, hardware/software, and contact information.
Course Outline	Provides a detailed outline of the course.
Course Overview	The course overview explains how to get around the course, outlines the course objectives and contents, describes the intended audience, and provides an estimate of the time to complete the entire course.
Basics	Basics of Managed Care.
Clinic Activity	Clinic Activities and Billing Activities.
Case Studies	Putting it all together.
Action Planning	Techniques to Assist in Changing Clinic Activities.
Glossary	Glossary of Terms.
Resources	A list of other sources of information on managed care and healthcare.
Evaluation	An opportunity to give feedback on this course.

Cicatelli Associates Incorporated, 505 Eighth Avenue, Suite 1600, New York, NY 10018
phone: (212) 594-7741 / fax: (212) 629-3321
http://www.cicatelli.org